Association Between Medication Use and Performance on Higher Education Entrance Tests in Individuals With Attention-Deficit/Hyperactivity Disorder

Lu, Yi; Sjölander, Arvid; Cederlöf, Martin; D’Onofrio, Brian M.; Almqvist, Catarina; Larsson, Henrik; Lichtenstein, Paul

doi:10.1001/jamapsychiatry.2017.1472

Cited by 45 publications

(23 citation statements)

References 53 publications

(109 reference statements)

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“…The children also received other supportive and educational treatments. Similar improvement in learning abilities by pharmacological treatment was demonstrated in adults by Lu et al [39] as well as by other investigators. Improved educational achievements also have benefits in reducing crime rate and in decreasing accidents and drug dependence.…”

Section: Introductionsupporting

confidence: 87%

Cost effectiveness of optimal treatment of ADHD in Israel: a suggestion for national policy

Ornoy¹,

Spivak

2019

Health Econ Rev

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ObjectivesThere are well known behavioral complications of ADHD at adulthood such as learning difficulties resulting in lower education attainments; increased rate of car and other accidents; substance abuse; misconduct and imprisonment. These complications can be prevented or alleviated by effective treatment. In this study we calculated the economic burden of ADHD among adults in Israel and the cost of diagnosing and treating ADHD from childhood to adulthood. We then obtained the cost-benefit ratio of the treatment.MethodsThe data were calculated using accepted estimations of prevalence and cost for the Israeli population assuming a prevalence of 4% among adults which is based on the ADHD prevalence among school age children.ResultsThe estimated cost per person with ADHD due to lower education attainment, higher involvement in crime and car accidents and more drug abuse is 289,969 USD and the estimated cost for optimal treatment is 41,667 USD. Hence, the benefit cost ratio is 7.02 and, assuming only 50% success of treatment, it is 3.51, still a very high cost benefit ratio.ConclusionsSince early diagnosis and appropriate treatment of ADHD is very effective in reducing the various symptoms and complications at adulthood thus enabling a better education and higher income, it seems important to diagnose and offer comprehensive treatment to children with ADHD. Moreover, it seems equally important to continue treatment at adulthood.

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Section: Introductionsupporting

confidence: 87%

Cost effectiveness of optimal treatment of ADHD in Israel: a suggestion for national policy

Ornoy¹,

Spivak

2019

Health Econ Rev

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“…This is line with previous studies which demonstrated clinical benefits of psychostimulant medication at 12 months [ 42 ] and 24 months [ 3 , 4 ]; however, the clinical benefits of psychostimulant medication (when naturalistically assessed) are not empirically supported for longer follow-up periods of 2–8 years [ 43 – 45 ]. Despite this, recent epidemiological studies have found that continued controlled medication intake can have positive benefits for patients with ADHD [ 46 – 48 ]. However, Swanson et al [ 49 ] reported that at 12–16-year follow-up of long-term medication use (both consistent and inconsistent use over this time period) was not associated with reduced symptom severity, but it was associated with decreased adult height.…”

Section: Discussionmentioning

confidence: 99%

Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis

Doren

Arns

Heinrich

et al. 2018

Eur Child Adolesc Psychiatry

242

178

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Neurofeedback (NF) has gained increasing interest in the treatment of attention-deficit/hyperactivity disorder (ADHD). Given learning principles underlie NF, lasting clinical treatment effects may be expected. This systematic review and meta-analysis addresses the sustainability of neurofeedback and control treatment effects by considering randomized controlled studies that conducted follow-up (FU; 2-12 months) assessments among children with ADHD. PubMed and Scopus databases were searched through November 2017. Within-group and between-group standardized mean differences (SMD) of parent behavior ratings were calculated and analyzed. Ten studies met inclusion criteria (NF: ten studies, N = 256; control: nine studies, N = 250). Within-group NF effects on inattention were of medium effect size (ES) (SMD = 0.64) at post-treatment and increased to a large ES (SMD = 0.80) at FU. Regarding hyperactivity/impulsivity, NF ES were medium at post-treatment (SMD = 0.50) and FU (SMD = 0.61). Non-active control conditions yielded a small significant ES on inattention at posttreatment (SMD = 0.28) but no significant ES at FU. Active treatments (mainly methylphenidate), had large ES for inattention (post: SMD = 1.08; FU: SMD = 1.06) and medium ES for hyperactivity/impulsivity (post: SMD = 0.74; FU: SMD = 0.67). Between-group analyses also revealed an advantage of NF over non-active controls [inattention (post: SMD = 0.38; FU: SMD = 0.57); hyperactivity-impulsivity (post: SMD = 0.25; FU: SMD = 0.39)], and favored active controls for inattention only at pre-post (SMD = − 0.44). Compared to non-active control treatments, NF appears to have more durable treatment effects, for at least 6 months following treatment. More studies are needed for a properly powered comparison of follow-up effects between NF and active treatments and to further control for non-specific effects.

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“…7,14,15 Observational studies exploring short-term effects have found converging evidence. 16,17 One recent study using Swedish register data found that, although of small effect, individuals (mean age 22.2 years) performed better on higher education entrance tests during medicated than unmedicated periods 16 and another study in children using a similar design found that GPA was higher during stimulant adherent periods. 17 Ideally, the long-term association between ADHD medication and school performance should be examined in large prospective RCTs, but since such trials are problematic (e.g., patients assigned to a long-term untreated control arm may seek out medications elsewhere) and unethical (e.g., withholding treatment with known benefits), future research in this area must rely on findings from observational designs.…”

Section: Introductionmentioning

confidence: 99%

Attention-Deficit/Hyperactivity Disorder, School Performance, and Effect of Medication

Jangmo

Stålhandske

Chang

et al. 2019

Journal of the American Academy of Child & Adolescent Psych

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125

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Objective: Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk of poor school performance and pharmacological treatment of ADHD may have beneficial effects on school performance. Conclusions from previous research have been limited by small sample sizes, outcome measures, and treatment follow-up. The current study analyzed school performance in students with ADHD compared to students without ADHD, and the association between pharmacological treatment of ADHD and school performance. Method: A linkage of Swedish national registers covering 657,720 students graduating from year 9 of compulsory school provided measures of school performance, electronically recorded dispensations of ADHD medication, and potentially confounding background factors such as parental socioeconomic status. Primary measures of school performance included student eligibility to upper secondary school and grade point sum. Results: ADHD was associated with substantially lower school performance independent of socioeconomic background factors. Treatment with ADHD medication for 3 months was positively associated with all primary outcomes, including a decreased risk of no eligibility to

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Association Between Medication Use and Performance on Higher Education Entrance Tests in Individuals With Attention-Deficit/Hyperactivity Disorder

Cited by 45 publications

References 53 publications

Cost effectiveness of optimal treatment of ADHD in Israel: a suggestion for national policy

Cost effectiveness of optimal treatment of ADHD in Israel: a suggestion for national policy

Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis

Attention-Deficit/Hyperactivity Disorder, School Performance, and Effect of Medication

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