ADHD Symptoms vs. Impairment: Revisited

Barkley, Russell A.; Cunningham, Charles E.; Gordon, Michael S.; Faraone, Stephen V.; Lewandowski, Larry; Murphy, Kevin R.

doi:10.1521/adhd.2006.14.2.1

Cited by 45 publications

(41 citation statements)

References 10 publications

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“…Statistical assessment of PERMP total score (the primary endpoint) was conducted using a mixed linear model analysis of variance (ANOVA) for the average of classes 1 to 6 (postdose 2-16 h) and at each postdose class (2,4,8,12,14, and 16 h postdose). The model included sequence (placebo followed by 25 mg SHP465 MAS versus 25 mg SHP465 MAS followed by placebo), period (visit 4 versus visit 5), and treatment (placebo versus 25 mg SHP465 MAS) as fixed effects and participant within sequence as a random effect.…”

Section: Data Presentation and Statistical Analysismentioning

confidence: 99%

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Effects of SHP465 mixed amphetamine salts in adults with ADHD in a simulated adult workplace environment

Wigal¹,

Childress

Frick

et al. 2017

Postgraduate Medicine

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Objectives: Evaluate the efficacy, duration of effect, and safety of 25 mg SHP465 mixed amphetamine salts (MAS) extended-release versus placebo in adults with attention-deficit/hyperactivity disorder (ADHD). Methods: Adults (18-55 years) with ADHD and with ADHD Rating Scale-IV (ADHD-RS-IV) scores ≥24 were randomized to treatment in a double-blind, 2-period, 2-treatment crossover study utilizing the Adult Workplace Environment (AWE), as described by Wigal and Wigal (J Atten Disord 2006;10:92-111). On day 7 of each 7-day treatment period, efficacy was assessed during a 16.5-hour postdose period. The primary endpoint, Permanent Product Measure of Performance (PERMP) total score, was analyzed in the intent-to-treat population using a mixed linear model of analysis of variance. Secondary endpoints, for which the study was not powered, included PERMP problems attempted and answered correctly, ADHD clinician ratings based on counselor observations and inputs during the Time Segment Rating System (Co-ADHD-RS TSRS), and the ADHD self-rating scale (ADHD-SRS). Safety and tolerability assessments included treatment-emergent adverse events (TEAEs) and vital signs. Results: The least squares mean (95% CI) treatment difference (SHP465 MAS-placebo) for PERMP total score significantly favored SHP465 MAS over placebo when averaged across all postdose assessments (19.29 [10.95, 27.63]; P < 0.0001), with significant treatment differences favoring SHP465 MAS over placebo observed at 4-16 hours postdose (all P < 0.01). TEAEs observed with SHP465 MAS (≥5% of participants) included insomnia, decreased appetite, dry mouth, headache, and anorexia. Mean pulse and blood pressure increases with SHP465 MAS exceeded those of placebo. Conclusions: SHP465 MAS (25 mg) was superior to placebo on PERMP total score, with treatment differences observed from 4 to 16 hours postdose; nominal treatment differences on the ADHD-SRS, but not the Co-ADHD-RS TSRS, were also observed. The safety and tolerability profile of SHP465 MAS was similar to previous reports for SHP465 MAS and other long-acting

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Section: Data Presentation and Statistical Analysismentioning

confidence: 99%

“…The presence of ADHD in adults is associated with difficulties in daily functioning, including impaired educational, occupational, and social function [4][5][6][7], and decreased work performance [8].…”

Section: Introductionmentioning

confidence: 99%

Effects of SHP465 mixed amphetamine salts in adults with ADHD in a simulated adult workplace environment

Wigal¹,

Childress

Frick

et al. 2017

Postgraduate Medicine

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“…It should be noted that even within the DSM-IV and DSM-V symptom lists, some symptoms may overlap with impairment. For example, avoiding tasks that require sustained mental effort (a symptom) could be a mere consequence (i.e., impairment) of another symptom being distractible 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Lack of clarity of what impairment is (or how it can be measured) or even the assumption that symptoms and impairment are equivalent dimensions may underlie the inconsistent use of impairment measures 4,5 . Overlooking impairment leads to false positive diagnoses and overestimates of prevalence rates 6 .…”

Section: Introductionmentioning

confidence: 99%

Quantitative measurement of impairment in ADHD: perspectives for research and clinical practice

Fortes¹,

Serra-Pinheiro²,

Coutinho³

et al. 2014

Arch. Clin. Psychiatry (São Saulo)

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Background: Functional impairment is needed to make an attention deficit hyperactivity disorder (ADHD) diagnosis, but there is a paucity of instruments addressing this issue. Objective: Perform psychometric analysis of a functional impairment scale (FIE). Methods: A sample of 320 individuals, including ADHD probands, their siblings and parents, filled the FIE. We analyzed psychometric properties for the entire sample and age groups. Factor structure was determined by a principal component factor analysis, using oblique rotation with Kaiser normalization and Eigenvalues higher than 1. Cronbach's alpha and SpearmanBrown were calculated. Results: Family analysis revealed four components: a) "family life", b) "self-perception", c) "performance" and d) "social life". Adults' analysis revealed two components: a) "family life, social life and self-perception" and b) "performance". Children showed the domains: a) "performance and social life", b) "self-perception" and c) "family life" components. Cronbach's alpha were above 0.9 in all components. Discussion: Results revealed up to four domains depending on the group considered. Different life demands might explain the variability of domains on the groups.

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“…Different research employing several methodologies (such as cohort and comparative studies) using DSM-III system criteria convincingly pointed out to the existence of impairment of multiple domains of ADHD patient's life 3,4 . The assessment of quality of life (QoL) indicators is frequently suggested as necessary to a better understanding of ADHD-associated impairment since the correlation between number of symptoms and the impact degree is uncertain 5,6 . Quality-of-life indices have been used in medical practice not only to estimate the impact of different diseases on functioning and well--being but also to compare outcomes between different treatment modalities.…”

Section: Introductionmentioning

confidence: 99%

Validade de constructo e confiabilidade da versão em língua portuguesa do Questionário de Qualidade de Vida em Adultos que apresentam TDAH (AAQoL)

Mattos¹,

Segenreich²,

Dias³

et al. 2011

Rev. psiquiatr. clín.

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Background: Several studies demonstrate that attention deficit hyperactivity disorder (ADHD) in adults is related to worse measures of quality of life. Objective: To evaluate the reliability and construct validity of the Portuguese version of the Adult ADHD Quality of Life Questionnaire (AAQoL). Methods: Adults with age ranging from 18 to 60 years old were included in this study. According to their diagnostic status they were divided into three groups: a) ADHD subjects using DSM-IV criteria; b) subjects with subthreshold ADHD; c) control comparison group without ADHD. The following questionnaires were applied: ASRS; SF-36 and AAQoL. The first part of the study evaluated the construct validity of the instrument and in the second part its reliability was tested. Results: ADHD, subthreshold ADHD and control groups comprised 29, 18 and 29 subjects, respectively. We found a negative correlation between the number of symptoms (ASRS) and the AAQoL total score considering all three groups. ADHD group presented worse levels of quality of life when compared to control group. As a whole, AAQol scores had significant correlation with SF-36 scores. Results indicated high levels of internal consistency and test-retest reliability. Discussion: The AAQoL construct presented high internal consistency of items, stability and construct validity.

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ADHD Symptoms vs. Impairment: Revisited

Cited by 45 publications

References 10 publications

Effects of SHP465 mixed amphetamine salts in adults with ADHD in a simulated adult workplace environment

Effects of SHP465 mixed amphetamine salts in adults with ADHD in a simulated adult workplace environment

Quantitative measurement of impairment in ADHD: perspectives for research and clinical practice

Validade de constructo e confiabilidade da versão em língua portuguesa do Questionário de Qualidade de Vida em Adultos que apresentam TDAH (AAQoL)

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