The Impact of Childhood Attention-Deficit/Hyperactivity Disorder (ADHD) on Children’s Health-Related Quality of Life: A Systematic Review and Meta-Analysis

Abstract

Objective: To investigate the association between children’s health-related quality of life (HRQoL) and childhood attention-deficit/hyperactivity disorder (ADHD). Method: Databases were systematically searched for peer-reviewed literature published between 2010 and 2022. Two reviewers independently screened and assessed the quality of included studies. Meta-analysis was conducted for studies that used the Pediatric Quality of Life Inventory (PedsQL). Results: Twenty-three studies were included, with most rated as “good” quality. Meta-analysis found “very large” effect in both parent- (Hedges’ g −1.67, 95% CI [−2.57, −0.78]) and child-reported (Hedges’ g −1.28, 95% CI [−2.01, −0.56]) HRQoL for children with ADHD compared to children without ADHD. No difference between parent- and child-reported HRQoL in children with and without ADHD was found. However, parent-reported HRQoL was lower than child-reported HRQoL among children with ADHD. Conclusion: ADHD was associated with substantially poorer children’s HRQoL. Among children with ADHD, parents rated their children’s HRQoL lower than the children themselves.

Is Attention-Deficit/Hyperactivity Disorder (ADHD) a Dimension or a Category? What Does the Relationship Between ADHD Traits and Psychosocial Quality of Life Tell Us?

“…Studies have shown that children with ADHD at a group level experience lower psychosocial QoL compared to their neurotypical peers without ADHD (Danckaerts et al, 2010; Lee et al, 2016; Wanni Arachchige Dona et al, 2023). The findings of the present study suggest that these differences are quantitative rather than qualitative in nature.…”

“…Other strengths were the inclusion of a large and representative general population sample of 1,967 schoolchildren (see Arildskov, Virring, et al, 2022 for details regarding representativeness) and the inclusion of validated rating scales (Niclasen et al, 2012; Szomlaiski et al, 2009; Varni et al, 2001, 2006). Although we included a generic measure of psychosocial QoL—the PedsQL—this measure is widely applied in studies of ADHD (Lee et al, 2016; Wanni Arachchige Dona et al, 2023), and is considered a reliable and valid school population health measure (Varni et al, 2006). There are also limitations of the study.…”

“…To date, most studies on psychosocial QoL have compared clinical samples of neurodivergent children with ADHD to (neurotypical) comparison groups of children without ADHD (e.g., Wanni Arachchige Dona et al, 2023). Here, children with ADHD have quite consistently been found to have significantly lower psychosocial QoL at a group level compared to their peers without ADHD.…”

“…Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition prevalent in 5% of children and adolescents world-wide (Polanczyk et al, 2007). At a group level, ADHD is associated with several adverse outcomes (Faraone et al, 2021) including reduced psychosocial (health-related) quality of life (QoL; Danckaerts et al, 2010;Lee et al, 2016;Wanni Arachchige Dona et al, 2023). Whereas several definitions of QoL exist (e.g., Coghill et al, 2009), the World Health Organization's QoL group defines the construct as "the individual's perception of their position in life, in the context of culture and value systems in which they live, and in relation to their goals, expectations, standards andconcerns" (WHOQOL, 1995, p. 1405).…”

Life Gets Better: Important Resilience Factors When Growing Up With ADHD

“…However, the value of non-pharmacological interventions (e.g., parenting interventions, Cognitive Behavior Therapy [CBT], and social skills) has been emphasized (National Institute for Health and Care Excellence, 2018). Children who receive treatment, both medication and non-pharmacological, have better QoL, self-esteem, and academic results than children not receiving treatment (Arnold et al, 2020;Dona et al, 2023;Harpin et al, 2016).…”