The Association between Prosocial Behaviour and Peer Relationships with Comorbid Externalizing Disorders and Quality of Life in Treatment-Naïve Children and Adolescents with Attention Deficit Hyperactivity Disorder.

Several recent studies confirmed that Attention Deficit Hyperactivity Disorder (ADHD) has a negative influence on peer relationship and quality of life in children. The aim of the current study is to investigate the association between prosocial behaviour, peer relationships and quality of life in treatment naïve ADHD samples. The samples included 79 children with ADHD (64 boys and 15 girls, mean age = 10.24 years, SD = 2.51) and 54 healthy control children (30 boys and 23 girls, mean age = 9.66 years, SD = 1.73). Measurements included: The "Mini International Neuropsychiatric Interview Kid; Strengths and Difficulties Questionnaire" and the "Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen". The ADHD group showed significantly lower levels of prosocial behaviour and more problems with peer relationships than the control group. Prosocial behaviour has a weak positive correlation with the rating of the child's quality of life by the parents, both in the ADHD group and in the control group. The rating of quality of life and peer relationship problems by the parents also showed a significant negative moderate association in both groups. The rating of quality of life by the child showed a significant negative weak relationship with peer relationships in the ADHD group, but no significant relationship was found in the control group. Children with ADHD and comorbid externalizing disorders showed more problems in peer relationships than ADHD without comorbid externalizing disorders. Based on these results, we conclude that therapy for ADHD focused on improvement of prosocial behaviour and peer relationships as well as comorbid externalizing disorders could have a favourable effect on the quality of life of these children.

Dyskinesia in Treatment-Naive and Stimulant-Treated Children With ADHD.

Objective: Stimulants are safe and effective medications for the treatment of ADHD. There are a number of case studies that report stimulant-induced dyskinesia. The aim of this study was to compare dyskinesia in a treated and a treatment-naive group of children with ADHD, and a healthy control group. Method: Children aged 6 to 18 years were involved in the study (n = 158). Diagnosis of ADHD was measured with the Mini International Neuropsychiatric Interview Kid (MINI Kid). Dyskinesia was assessed with the Abnormal Involuntary Movement Scale (AIMS). Results: Before methylphenidate administration, the treated ADHD group showed significantly higher AIMS total score than the control group (p = .001) and the treatment-naive ADHD group (p < .001). We found the same pattern 1.5 hr after methylphenidate administration. Conclusion: These results call attention that clinicians should take special care for the possible development of dyskinesia during the treatment of their ADHD patients with methylphenidate.

Psychiatric diagnoses in "healthy" control group of a clinical study and its effects on health related quality of life.

BACKGROUND: The measure of health-related quality of life (HRQoL) among children with mental disorders is still in early ages, even though the worldwide-pooled prevalence of psychiatric diagnoses among children and adolescents is around 13%. Several studies confirmed that these children have impaired social and school functioning and low HRQoL. Mental disorders among children often remain undiagnosed or diagnosed too late, in that case additional negative effects could be expected. The aim of the current study was to identify psychiatric disorders in children who participated in a clinical study as a "healthy" control group and measure its effects on HRQoL. METHODS: The inclusion criteria for control participated children were not having ongoing or previous psychiatric or psychological treatment. In the second step control children (n=79, age range 6-15) were divided into two subgroups according to achieved diagnostic criteria. Measures were Mini International Neuropsychiatric Interview Kid and Inventory for the Assessment of the Quality of Life in Children and Adolescents. For data analyzing due to unequal sample sizes robust Welch t-test with omega squared, Spearman's rank correlation coefficients and logistic regression were applied. RESULTS: According to the children and parents control group with diagnoses have lower HRQoL in school, peer relationships and mental health dimensions than control group without diagnoses. Furthermore, by the children's report this difference exists in the domain of time spent alone, by the parent proxy report exist in the somatic health and general dimensions. An increasing number of diagnoses decreased HRQoL in most areas. The presence of psychiatric diagnoses by children increase 8 times more likely to have low HRQoL in the domain of school and 4 times in the domain of time spent alone. CONCLUSIONS: These results draw attention to the relative high ratio of undiagnosed mental disorders in the control group and for the low HRQoL of these children. Screening of psychiatric disorders in schools should be crucial and the earliest recourse of treatment in the identified children. The findings of this study also underline the importance of assessing HRQoL from different perspectives.

Long-Term Effects of Multimodal Treatment on Psychopathology and Health-Related Quality of Life of Children With Attention Deficit Hyperactivity Disorder.

AIM: The current study aimed to examine the association between long-term (36 months) multimodal (pharmacological and psychological) treatment and psychopathology and health-related quality of life (HRQoL) in children with attention deficit/hyperactivity disorder (ADHD) from the perspectives of both the children and parents. METHODS: The sample consisted of 23 children with ADHD (21 boys, 2 girls, mean age = 13.46 years, SD = 2.36) and 23 healthy control children (11 boys, 12 girls, mean age = 12.49 years, SD = 1.75). The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) was applied to measure psychopathology and both parent and self-rated versions of the Inventory for the Measure of the Quality of Life in Children and Adolescents were used to assess HRQoL at baseline and at the 36-month follow-up visit. The ADHD group took part in multimodal (medical and behavioral) therapy. The healthy control group did not get any intervention. RESULTS: At the baseline, the ADHD group was characterized with higher scores in nine MINI Kid scales and showed lower HRQoL than the control group according to both children and their parents. At the 36-month follow-up visit six scale scores (ADHD, social phobia, oppositional defiance and conduct disorder, major depressive episode, dysthymic disorder) showed statistically significant decreases in the ADHD group, while these scores were constant in the control group. Parent-rated HRQoL was significantly lower in the clinical group at baseline than at the end of the study, but there were no significant changes in the control group. Self-reported changes in HRQoL matched parent-reported changes. INTERPRETATION: Multimodal therapy is associated with decreased psychopathology and improved HRQoL over the long term.

Direct Self-Injurious Behavior (D-SIB) and Life Events among Vocational School and High School Students.

Although several studies have recently assessed direct self-injurious behavior (D-SIB) among adolescents, it is still understudied in adolescents attending vocational schools: an educational setting generally associated with lower socioeconomic status. After extending the "Saving and Empowering Young Lives in Europe" (SEYLE) project to a vocational school population, we examined their D-SIB and life event characteristics compared to the high school population. SEYLE's Hungarian randomly selected high school sample (N = 995) was completed with a randomly selected vocational school sample (N = 140) in Budapest, Hungary. Participants aged 14⁻17 years completed the SEYLE project's self-administered questionnaires. D-SIB lifetime prevalence was significantly higher (29.4%) in the vocational school group compared to the high school group (17.2%) (Χ²(1) = 12.231, p< 0.001). D-SIB was associated with suicidal ideation in the vocational school group. Different life events were more frequent in the high school than in the vocational school group, and associations between D-SIB and life events differed in the vocational school group compared to the high school group. In conclusion, vocational school students are a vulnerable population with a higher prevalence of D-SIB compared to high school students. Life events and their association with D-SIB also differ in vocational school students compared to high school students. Taking all these into account might contribute to prevention/intervention designed for this population.

[Cross-Informant Agreement Between Parent-Reported and Adolescent Self-Reported Quality of Life in children with externalising symptoms].

BACKGROUND: It is well-known phenomena both in clinical practice and research, that there is a discrepancy between the parents' and children's report about children's Quality of Life (QoL). The purpose of our research was to examine the differences in self and caregiver's proxy report of child's QoL. We also compared mothers', fathers' and other caregivers' reports of children's QoL. METHODS: Patients with externalizing symptoms in their history, aged 13-18 years were selected from the Vadaskert Child and Adolescent Psychiatry Hospital and Outpatient Clinic. We used the Inventory of Quality of Life in Children and Adolescents (QL), parent and children version to measure the children's QoL. We used F-factor analysis (Principal Component Analysis and direct oblimin rotation) and t-tests for data analysis. RESULTS: Altogether 138 caregiver-child dyads filled the QL. The adolescents mean age was 14.47 years (SD=.40). Seventy-four mothers, 37 fathers and 27 other caregivers were included into our study. The caregivers' ratings were settled sorted into three factors, the adolescents' ratings were settled sorted into two factors. We found significant differences between mothers, fathers and other caregivers' ratings in the following domains of QoL: school, loneliness, peer relations, physical health, mental health and problem/illness. The caregivers evaluated adolescents' QoL more positively then the adolescents did (t=761, df=139, p<0,0001). CONCLUSIONS: The caregivers and their children's reported different domains of QoL as problematic. Therefore, it is important to gain information from several sources about the adolescent's QoL.

Self- and Parent-Rated Quality of Life of a Treatment Naïve Sample of Children With ADHD: The Impact of Age, Gender, Type of ADHD, and Comorbid Psychiatric Conditions According to Both a Categorical and a Dimensional Approach.

OBJECTIVE: Our aim was to evaluate the Quality of Life (QoL) of treatment naïve children with ADHD. METHOD: Data from 178 parent-child dyads were analyzed using multiple regression to assess the relationships between QoL, and characteristics of ADHD and comorbid psychopathology. RESULTS: Lower self-reported QoL was associated with female gender, higher age, more symptoms of anxiety and trauma-related disorders in dimensional approach, and with the comorbid diagnoses of trauma-related disorders and oppositional defiant disorder (ODD)/conduct disorder (CD) in categorical approach. Lower parent-reported QoL was related to older age and increasing number of symptoms of mood and anxiety disorders on one hand, and any diagnosis of mood and anxiety disorders and ODD/CD on the other. CONCLUSION: Our results draw the attention to the importance of taking into account age, gender, and both self- and parent reports when measuring QoL of children with ADHD and both dimensional and categorical approaches should be used.

[Quality of life of newly diagnosed, treatment naive children and adolescents with attention-deficit hyperactivity disorder]. / Figyelemhiányos-hiperaktivitás zavrral frissen diagnosztizált, kezelésben még nem részesülo gyermekek és serdülok életminosége.

INTRODUCTION: Attention-deficit hyperactivity disorder (ADHD) is one of the most prevalent childhood psychiatric disorder, it affects around 3-12% of the children. ADHD is associated with numerous social and emotional impairments. Quality of life (QoL) studies of children with ADHD established low QoL in the most cases. Our aim was to examine QoL of children with ADHD according to the following aspects: age, children's self-report and parentproxy report, and we also would like to compare them with healthy control group along several dimensions of QoL. METHODS: The clinical group consist of a treatmant naive group of children with ADHD, who were just diagnosed in the Vadaskert Hospital. The healthy control group consist of children from elementary schools. The children of control group do not have ADHD and do not stand under psychological or psychiatrical treatment. In our study we applied Mini International Neuropsychiatric Interview Kid and Intervertat Lebensqualitat Kindern und Jugendlichen questionare. RESULTS: Compared children with ADHD to healthy control group they have significantly lower QoL at many areas (school, peer realtions, generally) due their self report. By parent's proxy report children with ADHD have lower QoL according to all of the QoL domains. Parents of children with ADHD reported significantly lower QoL for their children in the most areas (school, family, peer realtion, mental state, generally) then the affected children. Adolescent with ADHD have lower QoL in 3 domains (school, peer relations, generally) than children with ADHD, while children with ADHD have lower QoL in one dimension (being alone) compared with adolescents with ADHD. CONCLUSION: Based on our results children with ADHD compared to healthy control group have lower QoL in many dimensions and there are age-related differences in the assessment of QoL. Additionally, our study draw the attention to the differences of QoL assessment between children and parents.

[Quality of life of patients with attention-deficit/hyperactivity disorder: systematic review of the past 5 years]. / Figyelemhiányos-hiperaktivitás zavar diagnózisú gyermekek és felnöttek életminösége: az elmúlt öt év vizsgálatainak szisztematikus áttekintö tanulmánya.

AIMS: Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent childhood disorders which continues into adulthood in 30-60%. Many studies are interested in the examination of the impact of ADHD on QoL. The aim of the current study is to provide a systematic review of QoL studies in both children and adults with ADHD published in the past five years focusing on three domains: 1. The impact of ADHD on QoL 2. The impact of ADHD on QoL regarding age 3. The impact of ADHD on QoL regarding gender. METHOD: A systematic literature search was conducted using the following databases: sciencedirect.com and MEDLINE from 2008 to 2012. The following keywords were searched: quality of life, QoL, attention deficit/hyperactivity disorder, ADHD, gender differences, gender-related, age differences, age-related. We included studies into our review which investigated both adults and children. Papers in English, German and Hungarian were included. RESULTS: Fourteen relevant articles were identified, among them 13 articles were in English, one in German and there were no articles in Hungarian. All of the 14 articles confirmed the negative effects of ADHD on QoL. Four studies dealt with the effects of ADHD on QoL regarding age: one paper claimed that older people with ADHD have more impairments, but have better lefi-expectations than younger people with ADHD, one study claimed that increasing age raises the odds of poor QoL, while two studies did not find any changes on QoL of patients with ADHD regarding age. Three studies dealt with the effect of ADHD on QoL regarding the gender: two studies did not find difference on QoL of patients with ADHD, while one study found that women with ADHD have lower QoL. CONCLUSIONS: Based on the studies published in the last 5 years, patients with ADHD have lower QoL than healthy people; moreover, they have lower QoL in many areas than patients with several somatic or other mental illnesses. More studies are needed regarding the effects of ADHD on QoL by age and gender.