Health-Related Quality of Life and Family Impact in Children with Attention-Deficit/Hyperactivity Disorder and Co-Morbid Psychiatric Conditions

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent chronic disorders in childhood. The measurement of health-related quality of life (HRQOL) can compliment ADHD behavior rating scales and provide a more comprehensive understanding of the impact of ADHD and its treatment on the child's overall daily functioning and well-being. The purpose of the current study was to assess HRQOL from the perspective of pediatric patient self-report and parent proxy-report and family impact from the perspective of parents in children with ADHD ages 5 to 18 years being seen at a Pediatric Psychiatric Clinic utilizing the PedsQL(TM) 4.0 Generic Core Scales and Family Impact Module. For all PedsQL(TM) 4.0 Generic Core Scales, pediatric patients with ADHD and their parents reported statistically significant worse HRQOL than healthy children, with large effect sizes across all domains. More impaired generic HRQOL was significantly correlated with more severe ADHD symptoms as measured by the NICHQ Vanderbilt Total ADHD Symptom Score for parent proxy-report but not child self-report. More impaired family functioning was significantly correlated with more severe ADHD symptoms. Intraclass Correlations (ICC) between pediatric patient self-report and parent proxy-report across the PedsQL(TM) 4.0 Generic Core Scales were in the poor to fair agreement range. These findings have implications for future research and clinical practice with pediatric patients with ADHD and co-morbid psychiatric conditions and their families. Given the large effect sizes reported between the present sample and healthy children across all HRQOL domains, it is important that interventions designed for children with ADHD and co-morbid psychiatric conditions not only address psychosocial difficulties, but also the physical impairments that may result from medications and/or co-morbid psychiatric diagnoses such as anxiety or depression. Given our finding that greater ADHD symptomatology was significantly associated with greater negative family impact, interventions for this population should focus on mitigating the negative impact of ADHD and co-morbid psychiatric conditions on families, particularly related to the areas of parental worry, family relationships, and daily family activities.