scholarly journals A Service Evaluation to Determine the Efficacy of a Specialist Service for Adults with Attention-Deficit Hyperactivity Disorder in Norfolk and Waveney

2020 ◽  
Author(s):  
Danielle Wilson ◽  
Lisa Riches
Keyword(s):  
Adult Adhd ◽  
Rating Scale ◽  
Service Evaluation ◽  
Research Literature ◽  
Adhd Medication ◽  
Specialist Service ◽  
Hyperactivity Disorder ◽  
Comparison Results ◽  
Literature Evidence ◽  
The Impact

Rationale, aims & objectives: This evaluation was carried out in order to determine the efficacy of the Norfolk and Waveney Adult ADHD Service. With the service not commissioned to offer non-pharmacological support, and with a gap in the research literature, evidence on whether the service model was effective at reducing the impact of ADHD symptoms on service users was needed in order to justify longer term commissioning. Method: Case notes of 113 individuals going through their medication titration process were observed. Scores from the Weiss Functional Impairment Rating Scale (WFIRS), which was routinely collected in the service pre- and post- titration onto ADHD medication, were recorded for comparison. Results: A T test revealed significant improvements in functioning across all domains of the WFIRS after successful titration onto ADHD medication. However, 19.5% of the sample disengaged from the service prior to completing titration. A further 12.5% of the sample did not complete titration due to various factors discussed. Conclusion: While medication has been shown to be effective at improving impairment of functioning in adults with ADHD, high levels of disengagement suggest that more needs to be offered to this population.

scholarly journals Evaluation of an attention deficit hyperactivity disorder (ADHD) assessment & treatment service

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S338-S338
Author(s):  
Chan Nyein ◽  
David Oyewole
Keyword(s):  
Waiting Time ◽  
Adult Adhd ◽  
Service Evaluation ◽  
Adhd Medication ◽  
Female Ratio ◽  
North West ◽  
Hyperactivity Disorder ◽  
Pre Treatment ◽  
Turn Over ◽  
Age Range

AimsThe Central and North West London NHS Foundation Trust ADHD clinic offers diagnosis and medication stabilisation for adults with ADHD, in preparation for discharge back to GP for continued prescribing and monitoring. Referral waiting time is shortened by efficiently managing the service and soon transfer of care to GP whilst referrals have been increasingly accepted years on years. A snap shot service evaluation was made to understand characteristics of service exploring its strength and areas to improve.MethodAll 115 patients offered in March and April 2019 for an ADHD specialist assessment were sampled from the new electronic patient record SystmOne in use since 1st March 2019.Data were collected forMale & Female ratioAge range distributionClinical Commissioning Group referral sourceClinic attendance characteristicsADHD diagnosis, sub-types and psychiatric comorbidityADHD Medication prescribedFP10 Prescription duration by prescribersPatient data were anonymously encoded into Microsoft Excel Sheet for sorting, counting, summating and illustrating into tables and pie charts.ResultThe male & female ratio of the sample was 6:5 and nearly half were in age range 20-29 years. Majority were referred from Westminster and West London Clinical Commissioning Groups.107 patients completed the assessment, of which 106 were diagnosed as having an adult ADHD.22% of follow-up clinics were cancelled or not attended (DNA) by patients. The majority of the patients (62%) required 1-2 follow-ups before transfer to GP, whilst 8% did not require or want follow-ups either already being on ADHD medication, not wanting medication or having lost to reviews. Only 3% require six or more follow-ups.Majority were reviewed after two- to five-week prescription, the peak being four-weekly.91% of completion to GP were discharged on ADHD medication, majority being singly on Elvanse (48%) and Concerta XL (25%). Discharge without ADHD medication was due to concerns for its addiction, preference on non-medication treatment, intolerance of medication adverse effect or mental health priority treatment.ConclusionCollaboration with GPs for their pre-treatment physical health screening facilitated prompt prescribing initiation on assessment with most discharges taken place after 1-2 follow-ups, enabling service turn-over with short waiting time (6-9 months in 2018/2019). Service expansion for increasing referral uptake is probably feasible from this baseline by appointing additional sessional clinicians and further efficiency management on clinic scheduling & DNA with a target majority likely requiring 1-2 follow-ups with average four-weekly prescribing.

scholarly journals Effectiveness of a digital therapeutic as adjunct to treatment with medication in pediatric ADHD

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Scott H. Kollins ◽  
Ann Childress ◽  
Andrew C. Heusser ◽  
Jacqueline Lutz
Keyword(s):  
Video Game ◽  
Primary Outcome ◽  
Rating Scale ◽  
Stimulant Medication ◽  
Additional Treatment ◽  
Adhd Medication ◽  
Open Label ◽  
Serious Adverse Events ◽  
Treatment Benefit ◽  
Hyperactivity Disorder

AbstractSTARS-Adjunct was a multicenter, open-label effectiveness study of AKL-T01, an app and video-game-based treatment for inattention, as an adjunct to pharmacotherapy in 8–14-year-old children with attention-deficit/hyperactivity disorder (ADHD) on stimulant medication (n = 130) or not on any ADHD medication (n = 76). Children used AKL-T01 for 4 weeks, followed by a 4-week pause and another 4-week treatment. The primary outcome was change in ADHD-related impairment (Impairment Rating Scale (IRS)) after 4 weeks. Secondary outcomes included changes in IRS, ADHD Rating Scale (ADHD-RS). and Clinical Global Impressions Scale—Improvement (CGI-I) on days 28, 56, and 84. IRS significantly improved in both cohorts (On Stimulants: −0.7, p < 0.001; No Stimulants: −0.5, p < 0.001) after 4 weeks. IRS, ADHD-RS, and CGI-I remained stable during the pause and improved with a second treatment period. The treatment was well-tolerated with no serious adverse events. STARS-Adjunct extends AKL-T01’s body of evidence to a medication-treated pediatric ADHD population, and suggests additional treatment benefit.

scholarly journals Clinical and social factors associated with attention-deficit hyperactivity disorder medication use: population-based longitudinal study

2014 ◽  
Vol 205 (4) ◽  
pp. 291-297 ◽  
Author(s):  
Cédric Galéra ◽  
Jean-Baptiste Pingault ◽  
Grégory Michel ◽  
Manuel-Pierre Bouvard ◽  
Maria Melchior ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Psychiatric Comorbidity ◽  
Medication Use ◽  
Population Based ◽  
Social Characteristics ◽  
Adhd Medication ◽  
Social Variables ◽  
Hyperactivity Disorder ◽  
The Impact

BackgroundThe impact of longitudinal psychiatric comorbidity, parenting and social characteristics on attention-deficit hyperactivity disorder (ADHD) medication use is still poorly understood.AimsTo assess the baseline and longitudinal influences of behavioural and environmental factors on ADHD medication use.MethodSurvival regressions with time-dependent covariates were used to model data from a population-based longitudinal birth cohort. The sample (n = 1920) was assessed from age 5 months to 10 years. Measures of children's psychiatric symptoms, parenting practices and social characteristics available at baseline and during follow-up were used to identify individual and family-level features associated with subsequent use of ADHD medication.ResultsUse of ADHD medication ranged from 0.2 to 8.6% between ages 3.5 to 10 years. Hyperactivity–inattention was the strongest predictor of medication use (hazard ratio (HR) = 2.75, 95% CI 2.35–3.22). Among all social variables examined, low maternal education increased the likelihood of medication use (HR = 2.09, 95% CI 1.38–3.18) whereas immigrant status lowered this likelihood (HR = 0.40, 95% CI 0.17–0.92).ConclusionsBeyond ADHD symptoms, the likelihood of receiving ADHD medication is predicted by social variables and not by psychiatric comorbidity or by parenting. This emphasises the need to improve global interventions by offering the same therapeutic opportunities (including medication) as those received by the rest of the population to some subgroups (i.e. immigrants) and by diminishing possible unnecessary prescriptions.

scholarly journals Objective Evaluation of Therapeutic Effects of ADHD Medication Using a Smart Watch: A Pilot Study

2020 ◽  
Vol 10 (17) ◽  
pp. 5946
Author(s):  
Chen-Sen Ouyang ◽  
Rei-Cheng Yang ◽  
Ching-Tai Chiang ◽  
Rong-Ching Wu ◽  
Lung-Chang Lin
Keyword(s):  
Rating Scale ◽  
Objective Evaluation ◽  
Therapeutic Effects ◽  
Adhd Medication ◽  
Objective Method ◽  
Analog Scale ◽  
Hyperactivity Disorder ◽  
Smart Watch ◽  
Before And After ◽  
Adhd Medications

Attention-deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in schoolchildren. Several methods are used to evaluate ADHD therapeutic effects, including the Swanson, Nolan, and Pelham (SNAP) questionnaire, the Vanderbilt ADHD Diagnostic Rating Scale, and the visual analog scale. However, these scales are subjective. In this study, we employed an objective method to evaluate the aforementioned therapeutic effects. Ten patients (nine boys and one girl) with ADHD were enrolled. An accelerometer was embedded in a smart watch to record the movements of patients with ADHD. The variance values of the accelerometer before and after one month of medication (methylphenidate) use were compared. The results demonstrated that the variance values along the y- and z-axes of the accelerometers significantly decreased after one month of methylphenidate use. Before and after one month of methylphenidate use, the variance values were 4.4227 ± 2.1723 and 2.3214 ± 0.6475 (p = 0.0119) on the y-axis, and 4.0933 ± 1.5720 and 2.4091 ± 0.8141 (p = 0.0140) on the z-axis, respectively. In addition, the correlation was moderate-to-strong between the SNAP hyperactivity subscale and variance along the y-axis. Thus, a smart watch with an accelerometer inside is potentially an objective and useful method for evaluating the therapeutic effects of ADHD medications.

Vortioxetine for attention deficit hyperactivity disorder in adults: A randomized, double-blind, placebo-controlled, proof-of-concept study

2019 ◽  
Vol 33 (4) ◽  
pp. 511-521 ◽  
Author(s):  
Joseph Biederman ◽  
Annika Lindsten ◽  
Lasse B Sluth ◽  
Maria Louise Petersen ◽  
Anders Ettrup ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Rating Scale ◽  
Stage I ◽  
Proof Of Concept ◽  
Double Blind ◽  
Patient Functioning ◽  
Concept Study ◽  
Hyperactivity Disorder

Background: Stimulants remain the mainstay of treatment for attention-deficit hyperactivity disorder (ADHD) but are often associated with insufficient response or poor tolerability, leading to many patients not wishing to be treated with controlled substances. Aims: This randomized, placebo-controlled, proof-of-concept study (NCT02327013) evaluated the efficacy of a multimodal antidepressant, vortioxetine, in the treatment of ADHD, using a two-stage sequential parallel comparison design. Methods: Patients aged 18–55 years with a diagnosis of ADHD (DSM-5) and a total score ⩾24 on the Adult ADHD Investigator Symptom Rating Scale (AISRS) were randomized in study stage I with a 1:1:3 ratio to six weeks of treatment with vortioxetine 10 or 20 mg/day, or placebo ( n = 227). In study stage II, placebo non-responders (AISRS total score reduction <30% from stage I baseline) were re-randomized with a 1:1:1 ratio to six weeks of vortioxetine 10 or 20 mg/day, or placebo ( n = 59). Results: Across the two study stages combined, ADHD symptoms improved by approximately eight AISRS points in all treatment groups, showing no difference from placebo for either dose of vortioxetine, the study thus failing to meet its primary endpoint. However, both doses of vortioxetine separated from placebo in improving overall patient functioning, as measured by the Sheehan Disability Scale. Conclusion: Studies are warranted to further investigate this suggested benefit of a multimodal antidepressant for patient functioning in ADHD while addressing issues of non-adherence and placebo response. The study confirmed vortioxetine 10 mg and 20 mg as generally well-tolerated.

Reliability, Criterion and Concurrent Validity of the Farsi Translation of DIVA-5: A Semi-Structured Diagnostic Interview for Adults With ADHD

2020 ◽  
pp. 108705472093081
Author(s):  
Lida Zamani ◽  
Zahra Shahrivar ◽  
Javad Alaghband-Rad ◽  
Vandad Sharifi ◽  
Elham Davoodi ◽  
...  
Keyword(s):  
Adult Adhd ◽  
Rating Scale ◽  
Diagnostic Interview ◽  
Self Report ◽  
Validity And Reliability ◽  
Clinical Interviews ◽  
Hyperactivity Disorder ◽  
Dsm 5 ◽  
Psychiatric Outpatient Clinic ◽  
Adult Outpatient

Objectives: This study evaluated the psychometrics of the Farsi translation of diagnostic interview for attention-deficit hyperactivity disorder (ADHD) in adults (DIVA-5) based on DSM-5 criteria. Methods: Referrals to a psychiatric outpatient clinic ( N = 120, 61.7% males, mean age 34.35 ± 9.84 years) presenting for an adult ADHD (AADHD) diagnosis, were evaluated using the structured clinical interviews for DSM-5 (SCID-5 & SCID-5-PD) and the DIVA-5. The participants completed Conner’s Adult ADHD Rating Scale-Self Report-Screening Version (CAARS-S-SV). Results: According to the SCID-5 and DIVA-5 diagnoses, 55% and 38% of the participants had ADHD, respectively. Diagnostic agreement was 81.66% between DIVA-5/SCID-5 diagnoses, 80% between SCID-5/CAARS-S-SV, and 71.66% between DIVA-5/CAARS-S-SV. Test–retest and inter-rater reliability results for the DIVA-5 were good to excellent. Conclusion: Findings support the validity and reliability of the Farsi translation of DIVA-5 among the Farsi-speaking adult outpatient population.

Incidence of Internet addiction in adult attention deficit hyperactivity disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S396-S397
Author(s):  
B. Tuzun Mutluer ◽  
T.G. Yener Orum ◽  
S. Sertcelik
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Internet Addiction ◽  
Attention Deficit ◽  
Internet Use ◽  
Adult Adhd ◽  
Rating Scale ◽  
Self Report ◽  
Adhd Symptoms ◽  
Hyperactivity Disorder ◽  
Dsm Iv

ObjectiveIn this study, it was aimed to determine the internet use properties of Adult Attention Deficit Hyperactivity Disorder (ADHD) patients who were followed-up at Haydarpasa Numune Research and Training Hospital, Psychiatry Department; ADHD Outpatient Clinic.MethodThirty participants who were diagnosed with adult ADHD aged between 18–31 years rated their ADHD symptoms in childhood retrospectively, using Wender Utah Rating Scale. Patients rated current adult ADHD symptoms with the Adult ADHD DSM-IV-Based Diagnostic Screening and Rating Scale (DSRS) and severity of symptoms measured by Adult ADHD Self-Report Scale (ASRS). Internet addiction (IA) was assessed with Young's Internet Addiction Scale (IAS). It was determined that, none of 30 Adult ADHD patients have been diagnosed with IA.29 of patient have moderate internet use although 1 of patients have risky internet use. The results revealed that total ASRS score (P = 0.020), total Adult ADHD DSM-IV-Based DSRS score (P = 0.036) and the Attention Deficit related properties subscale total score (P = 0.042) were significantly correlated with the IAS total score. Subscale of the self-report scales including; failing to finish schoolworks, chores, or duties at workplace, difficulty of following through on instructions (P = 0.017), restiveness; impaired inhibitory performance (P = 0.017), feeling not confident (P = 0.017), difficulty of managing time (P = 0.047), failing to give close attention to details or making careless mistakes (P = 0.037) are closely relevant to IAS total score.ResultIn conclusion, clinical features, which are characteristic of Adult ADHD could have same shared etiology with IA. Furthermore, ADHD patients are more likely to have an IA diagnosis. However, it was thought that this result had to be supported with studies including larger samples.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Diagnostic accuracy of a brief screening tool for attention deficit hyperactivity disorder in UK prison inmates

2016 ◽  
Vol 46 (7) ◽  
pp. 1449-1458 ◽  
Author(s):  
S. Young ◽  
R. A. González ◽  
L. Mutch ◽  
I. Mallet-Lambert ◽  
L. O'Rourke ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Diagnostic Accuracy ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Screening Tool ◽  
Rating Scale ◽  
Diagnostic Interview ◽  
Prison Inmates ◽  
Hyperactivity Disorder ◽  
Brief Screening

BackgroundAttention deficit hyperactivity disorder (ADHD) is overrepresented in prison, making it imperative to identify a screening tool that can be quickly applied to efficiently detect the disorder. We explored the discrimination ability of a widely used ADHD screen, the Barkley Adult ADHD Rating Scale (BAARS-IV), against a clinical diagnostic interview. A brief version of the screen was then developed in order to simplify its use in the prison context, and maximize its diagnostic properties.MethodA cross-sectional study of 390 male prison inmates was performed in the UK, all participants were screened and interviewed via the Diagnostic Interview for ADHD in Adults 2.0 (DIVA-2).ResultsA total of 47 (12.1%) inmates screened positive for ADHD using the full BAARS-IV, and 96 (24.6%) were clinically diagnosed, for a sensitivity of 37.9 and a specificity of 96.3. Our models identified the six items that most predicted ADHD diagnosis, with adjusted odds ratios ranging from 2.66 to 4.58. Sensitivity, specificity and accuracy were 0.82, 0.84 and 0.84, respectively, for the developed brief scale, and 0.71, 0.85 and 0.81 for its validation. Weighted probability scores produced an area under the curve of 0.89 for development, and 0.82 for validation of the brief scale.ConclusionsThe original BAARS-IV performed poorly at identifying prison inmates with ADHD. Our developed brief scale substantially improved diagnostic accuracy. The brief screening instrument has great potential to be used as an accurate and resource-effective tool to screen young people and adults for likely ADHD in the criminal justice system.

scholarly journals Study of Communication Skills in Children with Attention Deficit /Hyperactivity Disorder in Shahrekord

2020 ◽  
Vol 12 ◽  
pp. 39-54
Author(s):  
Maryam Sadat Ghiasian ◽  
Habib Shahabi ◽  
Mohammad Reza Ahmadkhani
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Rating Scale ◽  
Test Methods ◽  
Research Literature ◽  
Chi Square ◽  
Parent Questionnaire ◽  
Hyperactivity Disorder ◽  
Pragmatic Skills ◽  
Nonverbal Skills

Objective: This study was to investigate those pragmatic skills that children with attention deficit/hyperactivity disorder, especially children with pragmatic impairment, show in their colloquial interactions with their parents. Method: In this regard, all children aged 6 to 13 years old with a diagnostic criterion for attention deficit/hyperactivity disorder in a a center for learning disabilities in Shahrekord were selected as research participants in a census method. Required data were collected by using an ADHD rating scale–IV (DuPaul et al., 1998) as well as a Five to fifteen parent questionnaire and were examined through descriptive statistics and chi square test methods. Results: Findings showed that children with more hyperactivity were of more problem, especially in nonverbal skills (r=0.079; p≤0.05) and subject Maitaining skills (r=0.032, p≤0/05), than children with more attention deficit (r =0.00; p≤0.05). In addition, compared to girls, boys had more problems in subject Maitaining skills (p= 0.02) and non-verbal ones (p=0.014). The results of the analysis also showed that most issues related to pragmatic skills occur at younger ages and decrease with age. The study of previous research literature also confirmed that the low level of such skills can have adverse consequences for such children and pose serious risks to their future psychologically, educationally and behaviorally. Conclusion: Psychological interventions and educational strategies seem necessary to increase the level of these skills in children with this disorder.

scholarly journals The Impact of an Adapted Climbing Program on Children with Attention-Deficit/Hyperactivity Disorder

2020 ◽  
Vol 9 (4) ◽  
pp. 60-69
Author(s):  
Erin Angelini ◽  
Kathryn N Oriel ◽  
Greta M Myers ◽  
Kyle D.A. Cook ◽  
Ross M Drawbaugh ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Rating Scale ◽  
Route Planning ◽  
Rock Climbing ◽  
Moderate Intensity ◽  
Parent Rating ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
The Impact

Attention-Deficit/Hyperactivity Disorder impacts children’s participation in activities that require attention to instruction, sustained mental effort, and executive functioning. Physical activity has been correlated to improvement in attention in children with ADHD. Rock climbing challenges muscular endurance, attention, and route planning. Five participants, aged 8-13, participated in the climbing program. Attention was measured pre and post climbing intervention with Trail Making Test B (TMT-B) for time to complete. Exercise intensity was measured by heart rate. Parent feedback on behavior was collected with the Conner’s Parent Rating Scale (CPRS). The social validity of the intervention was measured by the IRP-15 measures. Statistically, significant intrasession attention improvements were noted in all 5 climbers (p=.43). Two climbers were consistently working at a moderate intensity (40-60% HRmax) while 3 climbers maintained a light level of intensity (20-40% HRmax). No statistically significant improvements were found on the CPRS, although improvements are noted with qualitative reports from parents. The IRP-15 showed 100% of parents believed rock climbing was an effective intervention for their children with ADHD. Rock climbing at a light to moderate intensity is associated with improvements in attention and behavior in children with ADHD.

Sign in / Sign up

Export Citation Format

Share Document