The effects of atomoxetine on emotional control in adults with ADHD: An integrated analysis of multicenter studies

2015 ◽  
Vol 30 (4) ◽  
pp. 511-520 ◽  
Author(s):  
P. Asherson ◽  
S. Stes ◽  
M. Nilsson Markhed ◽  
L. Berggren ◽  
P. Svanborg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Effect Size ◽  
Adult Adhd ◽  
Self Report ◽  
Integrated Analysis ◽  
Emotional Control ◽  
Adhd Symptoms ◽  
Multicenter Studies ◽  
Small Effect Size

AbstractPurpose:To investigate the effects of atomoxetine on emotional control in adults with ADHD.Methods:We performed an integrated analysis using individual patient data pooled from three Eli Lilly-sponsored studies. An integrated analysis can be viewed as a meta-analysis of individual patient-level data, rather than study-level summary data.Results:Two populations were identified: a large sample of patients with pre-treatment baseline data (the “overall population”; n = 2846); and a subset of these patients with placebo-controlled efficacy data from baseline to 10 or 12 weeks after initiating treatment (the “placebo-controlled population”; n = 829). At baseline, in the overall population, ∼50% of ADHD patients had BRIEF-AS (Behavior Rating Inventory of Executive Function-Adult Version Self-Report) Emotional control subscores between 21 and 30, compared with ∼10% of normative subjects in the BRIEF-A manual. At endpoint, in the placebo-controlled population, atomoxetine led to a small (effect size 0.19) but significant (P = 0.013) treatment effect for emotional control. The effect size was 0.32 in patients with BRIEF-AS Emotional control scores > 20 at baseline. Improvements in emotional control correlated with improvements in the core ADHD symptoms and quality-of-life.Discussion:As deficient emotional control is associated with impaired social, educational and occupational functioning over and above that explained by core ADHD symptoms alone, improvements in emotional control may be clinically relevant.Conclusion:At baseline, adults with ADHD were more likely to have impaired emotional control than normative subjects. In the adult ADHD patients, atomoxetine treatment was associated with improvements in emotional control, as well as in core ADHD symptoms and quality-of-life.

scholarly journals Emotional Dysregulation And Quality of Life In Young Adults With ADHD- A Cross Sectional Study

2021 ◽  
Author(s):  
Maayan Ben Dor Cohen ◽  
Eran Eldar ◽  
Adina Maeir ◽  
Mor Nahun
Keyword(s):  
Quality Of Life ◽  
Young Adults ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Emotional Dysregulation ◽  
Self Report ◽  
Adhd Group ◽  
Adhd Symptoms ◽  
Cross Sectional

Abstract Objective: Attention Deficit Hyperactivity Disorder (ADHD) is associated with emotional dysregulation (ED) and impaired quality of life (QoL). However, the role of ED in explaining the relationship between ADHD and QoL is unclear. The purpose of the present study was to do so in a sample of non-referred young adults with and without ADHD.Method: The study design was cross-sectional. A non-clinical sample of 62 young adults with ADHD (mean age = 24.86 years, SD = 3.25) and 69 controls (mean age = 23.84 years, SD = 2.59) were recruited. The Adult ADHD Quality-of-Life scale was used to measure QoL; The Adult ADHD Self-Report Scale was used to measure ADHD symptoms. The Self-Report Wender-Reimherr Adult Attention Deficit Disorder Scale and the Difficulties in Emotion Regulation Scale were used to measure ED. Group differences on all measures were tested using univariate and multivariate analyses of covariance, while controlling for age. Univariate analyses of variance were conducted to investigate the possible effect of medication on all outcome measures in the ADHD group. Finally, a moderation analysis was used in order to examine the impact of ED on QoL beyond that accounted for by ADHD symptoms.Results: Both QoL and ED were significantly worse for the ADHD group compared to the control group. The medication status of the ADHD group participants had no significant effect on the level of ADHD symptoms, ED or QoL. ED moderated the effect of ADHD symptoms on QoL for the ADHD group.Conclusion: The findings support the centrality of ED in ADHD and its crucial influence on QoL. Young adults with ADHD and high levels of ED are at risk for aversive impact on their well-being regardless of their ADHD symptoms level.

scholarly journals Program Evaluation of GLA:D® Australia: Physiotherapist Training Outcomes and Effectiveness of Implementation for People With Knee Osteoarthritis

2021 ◽  
Author(s):  
Christian Barton ◽  
Joanne Kemp ◽  
Ewa Roos ◽  
Soren Skou ◽  
Karen Dundules ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Exercise Therapy ◽  
Effect Size ◽  
Scale Up ◽  
Qualitative Evaluation ◽  
Effective Implementation ◽  
Small Effect Size ◽  
Patient Reported

Abstract BackgroundThe Good Life with osteoArthritis from Denmark (GLA:D®) program incorporates guideline-based patient education and exercise-therapy for osteoarthritis to implement guidelines into practice. We evaluated the implementation of GLA:D® for knee osteoarthritis within Australian physiotherapy practice using the RE-AIM QuEST (Reach, Effectiveness, Adoption, Implementation, Maintenance Qualitative Evaluation for Systematic Translation) framework.MethodsAustralian physiotherapists were trained and supported to deliver GLA:D® (2017-2019) and completed surveys before and after training to assess practices, beliefs about capabilities and confidence, and barriers and enablers to implementation. Patients participating in GLA:D® completed online baseline, 3-month (immediately post-treatment) and 12-month patient reported outcomes. Effective implementation was defined as within-subject moderate effect size (ES, ≥0.50) for average pain (100mm visual analogue scale) and knee osteoarthritis outcome score quality of life scores (KOOS-QoL), and small effect size (≥0.20) for health-related quality of life (EQ-5D-5L).ResultsReach: 1,064 physiotherapists (73% private) and 1,945 (79% private) from all states and territories consented to participation. Key barriers included out-of-pocket cost to patients, and program suitability for culturally and linguistically diverse communities. Effectiveness: Following training, more physiotherapists discussed treatment goals and the importance of weight management, and prescribed supervised, neuromuscular exercise. Patient outcomes at 3- and 12 months (n = 1,044 [54%] and 927 [48%]) reflected effective implementation, including reduced pain intensity (ES, 95%CI = 0.72, 0.62-0.84; and 0.65, 0.54-0.77), improved KOOS-QoL scores (0.79, 0.69-0.90; and 0.93, 0.81-1.04), and improved EQ-5D-5L scores (0.43, 0.31-0.54; and 0.46, 0.35-0.58). Seventy-three percent of participants reported minimal important changes for at least one of pain severity (≥ 15 mm), KOOS-QoL (≥ 15 points) or EQ-5D-5L (≥ 0.07 points). Adoption: GLA:D® was implemented at 297 sites (264 private, 33 public). Implementation: Most patients completed at least one education (90%), and 10 exercise-therapy (78%) sessions. Adequate staffing to support program delivery was a key enabler. Maintenance: Ninety-nine percent of sites (293/297) continued to offer the program in July 2020.ConclusionsTraining was associated with practice changes and widespread implementation of GLA:D® in Australia. Effective implementation, and clinically meaningful improvements in pain and quality of life for most participant, supports further work to scale up GLA:D® in Australia.

scholarly journals The Effect of Educational Intervention on Anxiety and Quality of Life Among Individuals Referring to Healthcare Centers in the Face of COVID-19

2021 ◽  
Author(s):  
Fariba Zahedifar ◽  
Zahra Nejatifar ◽  
Sima Rafiei ◽  
Fariba Hashemi
Keyword(s):  
Quality Of Life ◽  
Educational Intervention ◽  
Effect Size ◽  
Knowledge Score ◽  
Educational Interventions ◽  
Anxiety Control ◽  
Small Effect Size ◽  
Quasi Experimental ◽  
Most Significant Change

Educational interventions are helpful strategies to empower communities encountering the threat of pandemics like Covid-19. This study was carried out to examine the effect of educational intervention on anxiety control and improvement in public quality of life. A quasi-experimental study. The study was conducted among individuals referred to healthcare centers of Qazvin province, Iran, in 2020. Given that Qazvin consists of nine urban healthcare centers, two centers were selected by a simple random selection method. After considering inclusion and exclusion mentioned criteria, 240 individuals were selected to participate in the research and were randomly assigned into two groups of experimental and control. Following the educational intervention, all study variables, including knowledge score, anxiety level, and quality of life, improved significantly in the experimental group compared to the pre-intervention phase (P<0.05). The most significant change was in knowledge score with a nearly large effect size (0.63), presenting an increase of 40.09% from 11.1 to 18.8 exactly after intervention and 12.2 after passing one month from the date of educational intervention; while the quality of life presented a 3.2% increase with a small effect size (0.28). Our findings have implications for the development and implementation of psychological interventions, particularly educational programs. During the outbreak, such strategies can empower the public and diminish the negative emotional effects of the pandemic, helping people to cope with the current situation, and decrease the risk of suffering future psychological disorders.  

Functional and psychosocial impairment in adults with undiagnosed ADHD

2006 ◽  
Vol 37 (1) ◽  
pp. 97-107 ◽  
Author(s):  
STEPHEN L. ABLE ◽  
JOSEPH A. JOHNSTON ◽  
LENARD A. ADLER ◽  
RALPH W. SWINDLE
Keyword(s):  
Quality Of Life ◽  
Educational Attainment ◽  
Functional Impairment ◽  
Adult Adhd ◽  
Self Report ◽  
Administrative Claims ◽  
Psychosocial Impairment ◽  
Care Plans ◽  
Lower Educational Attainment

Background. Identify a group of adults with ‘undiagnosed’ attention deficit hyperactivity disorder (ADHD) and compare their personal and family medical histories, psychosocial profiles, functional impairment and quality of life with non-ADHD controls. Additionally, compare adults with undiagnosed and diagnosed ADHD to investigate possible reasons why the undiagnosed avoid clinical detection.Method. ICD-9 codes for ADHD in administrative claims records and responses to a telephone-administered adult ADHD screener [the Adult ADHD Self-Report Scale (ASRS)] were used to classify approximately 21000 members of two large managed health-care plans as ‘undiagnosed’ (no coded diagnosis; ASRS positive) or ‘non-ADHD’ controls (no coded diagnosis; ASRS negative). Patients identified as ‘undiagnosed’ ADHD were compared with samples of non-ADHD controls and ‘diagnosed’ ADHD patients (ICD-9 coded ADHD diagnoses) on the basis of demographics, socio-economic status, past and present mental health conditions, and self-reported functional and psychosocial impairment and quality of life.Results. A total of 752 ‘undiagnosed’ ADHD subjects, 199 ‘non-ADHD’ controls and 198 ‘diagnosed’ ADHD subjects completed a telephone interview. Overall, the ‘undiagnosed’ ADHD cohort demonstrated higher rates of co-morbid illness and greater functional impairment than ‘non-ADHD’ controls, including significantly higher rates of current depression, and problem drinking, lower educational attainment, and greater emotional and interpersonal difficulties. ‘Undiagnosed’ ADHD subjects reported a different racial composition and lower educational attainment than ‘diagnosed’ ADHD subjects.Conclusion. Individuals with ‘undiagnosed’ ADHD manifest significantly greater functional and psychosocial impairment than those screening negative for the disorder, suggesting that ADHD poses a serious burden to adults even when clinically unrecognized.

Health related quality of life in adults with ADHD symptoms: A population survey using 15D and AAQoL

2016 ◽  
Vol 33 (S1) ◽  
pp. S172-S173
Author(s):  
L. Alaheino ◽  
S. Leppämäki ◽  
T. Partonen ◽  
M. Sainio
Keyword(s):  
Quality Of Life ◽  
Adult Adhd ◽  
Self Report ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Difference ◽  
The Impact ◽  
Disease Specific

IntroductionHealth related quality of life (HRQoL) can be measured and compared, to give us an understanding of the impact different diseases have on health. The diagnostic tests for attention-deficit/hyperactive disorder (ADHD) in adulthood fail to catch the diversity of ways the condition affects one's life. Disease-specific quality-of-life scales try to reach beyond the typical symptoms of the condition, to find those specific difficulties a person subjectively grades as challenging.ObjectivesTo assess the levels of general and disease-specific HRQoL in adults with ADHD-like symptoms.AimsTo understand the impact ADHD-like symptoms have on adults’ HRQoL.MethodsA random, nationwide sample of 3000 Finnish speaking citizens (aged 18-44 years) was drawn from the national population register. A subsample of 171 people, 57 screener (Adult ADHD Self-Report Scale [ASRS]) positive cases and two age- and sex-matched controls for each case, participated in a telephone interview. General HRQoL was measured with 15D, and disease-specific HRQoL with Adult ADHD Quality-of-Life (AAQoL) scale.ResultsThe 15D score was 0.866 for the screener positives, 0.943 for the controls, and 0.945 for the Finnish population reference. The difference between the screener positives and controls was significant (P < 0.001). The AAQoL sum score was worse for the screener positives than controls (61.9 vs. 82.1, P < 0.001), and all the subscales were affected accordingly.ConclusionsAdults with ADHD-like symptoms have a lower quality of life, as measured both on the general and on the condition-specific quality of life scales.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Do Personality Traits Predict Functional Impairment and Quality of Life in Adult ADHD? A Controlled Study

2015 ◽  
Vol 23 (1) ◽  
pp. 12-21 ◽  
Author(s):  
J. Allison He ◽  
Kevin M. Antshel ◽  
Joseph Biederman ◽  
Stephen V. Faraone
Keyword(s):  
Quality Of Life ◽  
Personality Traits ◽  
Social Adjustment ◽  
Functional Impairment ◽  
Negative Binomial ◽  
Self Report ◽  
Controlled Study ◽  
Adhd Symptoms ◽  
Functional Impairments

Objective: To examine the association of personality traits and characteristics on quality of life and functioning in adults with ADHD. Method: Participants were adults with ( n = 206) and without ADHD ( n = 123) who completed the Temperament and Character Inventory (TCI), the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), and the Social Adjustment Scale–Self-Report (SAS-SR). Participants also provided information on academic, motor vehicle operation, legal, social, familial, and occupational functioning. Outcomes were examined using stepwise linear regression, logistic regression (for binary outcomes), and negative binomial regression (for count outcomes) controlling for ADHD symptoms, psychiatric comorbidity, and executive dysfunction. Results: Adults with ADHD significantly differed from controls across nearly all TCI personality domains. On average, adults with ADHD endorsed more novelty seeking, harm avoidance, and self-transcendence, and less reward dependence, persistence, self-directedness, and cooperativeness. Personality traits and characteristics, especially self-directedness, significantly predicted functional impairments even after controlling for ADHD symptoms, executive function deficits, and current psychiatric comorbidities. Conclusion: In adults with ADHD, personality traits exert unique associations on quality of life and functional impairment across major life domains, beyond the relations expected of and associated with ADHD symptoms and other associated psychiatric conditions and cognitive vulnerabilities. Addressing personality traits in adults with ADHD may lead to improvements in quality of life and reductions in functional impairment.

Self-Rated ADHD Symptoms Among Biological Mothers or Fathers of Children with Confirmed ADHD in a French Population

2016 ◽  
Vol 118 (1) ◽  
pp. 277-291 ◽  
Author(s):  
Amélie Dentz ◽  
Lucia Romo ◽  
Eric Konofal ◽  
Véronique Parent
Keyword(s):  
Adult Adhd ◽  
Rating Scale ◽  
Self Report ◽  
French Population ◽  
Adhd Symptoms ◽  
Parenting Strategies ◽  
Children With Adhd ◽  
Biological Mothers ◽  
Parental Adhd

Parents of children with ADHD are more likely to present the disorder, which can affect quality of life and parenting strategies. Few studies have examined parental ADHD to date, none in France. Prevalence of self-rated ADHD symptoms in adulthood and childhood was estimated among 60 biological mothers or fathers of children with confirmed ADHD in France. Cutoffs were total score ≥46 on the Wender Utah Rating Scale and ≥4 on the Adult ADHD Self-Report Scale Screener. Results indicated possible child and adult ADHD in 12.5% of mothers and 10.0% of fathers. As these percentages exceed reported prevalence rates for the French population, a greater effort must be made to diagnose the disorder in parents.

scholarly journals Quality of life in elderly ICU survivors before the COVID-19 pandemic: a systematic review and meta-analysis of cohort studies

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e045086
Author(s):  
Kevin Ariyo ◽  
Sergio Canestrini ◽  
Anthony S David ◽  
Alex Ruck Keene ◽  
Sebastian Wolfrum ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Decision Making ◽  
Cohort Studies ◽  
Effect Size ◽  
Meta Analysis ◽  
Qualitative Synthesis ◽  
Small Effect Size

ObjectivesThe influence of age on intensive care unit (ICU) decision-making is complex, and it is unclear if it is based on expected subjective or objective patient outcomes. To address recent concerns over age-based ICU decision-making, we explored patient-assessed quality of life (QoL) in ICU survivors before the COVID-19 pandemic.DesignA systematic review and meta-analysis of cohort studies published between January 2000 and April 2020, of elderly patients admitted to ICUs.Primary and secondary outcome measuresWe extracted data on self-reported QoL (EQ-5D composite score), demographic and clinical variables. Using a random-effect meta-analysis, we then compared QoL scores at follow-up to scores either before admission, age-matched population controls or younger ICU survivors. We conducted sensitivity analyses to study heterogeneity and bias and a qualitative synthesis of subscores.ResultsWe identified 2536 studies and included 22 for qualitative synthesis and 18 for meta-analysis (n=2326 elderly survivors). Elderly survivors’ QoL was significantly worse than younger ICU survivors, with a small-to-medium effect size (d=0.35 (−0.53 and −0.16)). Elderly survivors’ QoL was also significantly greater when measured slightly before ICU, compared with follow-up, with a small effect size (d=0.26 (−0.44 and −0.08)). Finally, their QoL was also marginally significantly worse than age-matched community controls, also with a small effect size (d=0.21 (−0.43 and 0.00)). Mortality rates and length of follow-up partly explained heterogeneity. Reductions in QoL seemed primarily due to physical health, rather than mental health items.ConclusionsThe results suggest that the proportionality of age as a determinant of ICU resource allocation should be kept under close review and that subjective QoL outcomes should inform person-centred decision -aking in elderly ICU patients.PROSPERO registration numberCRD42020181181.

The Vietnamese Version of the Health-related Quality of Life Measure for Children with Epilepsy (CHEQOL-25): Reliability

MedPharmRes ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. 9-14
Author(s):  
Tri Doan ◽  
Tuan Tran ◽  
Han Nguyen ◽  
◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Good Practice ◽  
The Self ◽  
Self Report ◽  
Health Related Quality ◽  
Life Measure ◽  
Related Quality ◽  
Health Related ◽  
Parent Proxy

Purpose: This study aimed to translate and culturally adapt the self-report and parent-proxy Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) into Vietnamese and to evaluate their reliability. Methods: Both English versions of the self-report and parent-proxy CHEQOL-25 were translated and culturally adapted into Vietnamese by using the Principles of Good Practice for the Translation and Cultural Adaptation Process. The Vietnamese versions were scored by 77 epileptic patients, who aged 8–15 years, and their parents/caregivers at neurology outpatient clinic of Children Hospital No. 2 – Ho Chi Minh City. Reliability of the questionnaires was determined by using Cronbach’s coefficient α and intra-class correlation coefficient (ICC). Results: Both Vietnamese versions of the self-report and parent-proxy CHEQOL-25 were shown to be consistent with the English ones, easy to understand for Vietnamese children and parents. Thus, no further modification was required. Cronbach’s α coefficient for each subscale of the Vietnamese version of the self-report and parent-proxy CHEQOL-25 was 0.65 to 0.86 and 0.83 to 0.86, respectively. The ICC for each subscale of the self-report and parent-proxy CHEQOL-25 was in the range of 0.61 to 0.86 and 0.77 to 0.98, respectively. Conclusion: The Vietnamese version of the self-report and parent-proxy CHEQOL-25 were the first questionnaires about quality of life of epileptic children in Vietnam. This Vietnamese version was shown to be reliable to assess the quality of life of children with epilepsy aged 8–15 years.

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