Impact of ADHD symptoms on family functioning, family burden and parents’ quality of life in a hospital area in Spain

Background and objectives: The aim of this study was to evaluate whether ADHD symptom severity and ADHD subtype are associated with family functioning, family burden and quality of life, in a sample of parents of children diagnosed with ADHD.MethodsSeventy-four parents of children diagnosed with ADHD were recruited at an Outpatient Child & Adolescent Mental Health Clinic in Madrid (Spain) and afterwards completed four electronical self-administered scales to determine their perceived family functioning, family burden and quality of life, as well as the severity and subtype of ADHD symptoms in their children.ResultsSeverity of children’s ADHD symptoms negatively affected parents’ quality of life, family functioning and family burden. Higher scores in inattention and combined subtypes were correlated with lower results in those domains. In adjusted correlations, the SWAN hyperactivity/impulsivity subscale significantly correlated with the four scales.ConclusionsThese results suggest that severity of the ADHD symptoms has a negative impact on parent’s quality of life and family functioning in inattention and combined subtypes. Family therapy and other interventions targeted towards improving family relationships and caregivers’ wellbeing should be considered when managing ADHD in the clinical practice. Electronic measurement tools are a promising method of evaluation in mental health research. (AU)

Computerized Adaptive Test vs. decision trees: Development of a support decision system to identify suicidal behavior.

BACKGROUND: Several Computerized Adaptive Tests (CATs) have been proposed to facilitate assessments in mental health. These tests are built in a standard way, disregarding useful and usually available information not included in the assessment scales that could increase the precision and utility of CATs, such as the history of suicide attempts. METHODS: Using the items of a previously developed scale for suicidal risk, we compared the performance of a standard CAT and a decision tree in a support decision system to identify suicidal behavior. We included the history of past suicide attempts as a class for the separation of patients in the decision tree. RESULTS: The decision tree needed an average of four items to achieve a similar accuracy than a standard CAT with nine items. The accuracy of the decision tree, obtained after 25 cross-validations, was 81.4%. A shortened test adapted for the separation of suicidal and non-suicidal patients was developed. CONCLUSION: CATs can be very useful tools for the assessment of suicidal risk. However, standard CATs do not use all the information that is available. A decision tree can improve the precision of the assessment since they are constructed using a priori information.