How do Hyperactive Children Feel About Taking Stimulants and Will They Tell the Doctor?

Abstract

There are no systematic data on the attitudes of hyperactive children toward treatment with stimulant medication. Such knowledge would be of aid to the physician in understanding the child, structuring therapy, and improving compliance; therefore we interviewed 52 hyperactive children who had been so treated. The outstanding findings were that a large fraction of the children disliked the medication and often tried to avoid taking it. The physician interview provides valuable information with some children, but for assurance of accuracy the clinician needs to use other sources of information.'ditr~r,~' dVote---A reviewer comments: &dquo;This is a fascinating paper documenting a high level of non-compliance with stimulant medication prescribed for hyperactivity in school children. Even more interestingly, it gives a great deal of anecdotal information to the effect that the interview method is not a reliable method for obtaining accurate information from children themselves about their feelings, behavior, and attitudes. Certainly, with the amount of stimulant medication being prescribed, very little has been said about treatment failure being due to non-compliance; and, of equal note, is that there must be a great many children who are thought to be improved because of their medication but are failing to take it.&dquo; ' SOME CLINICIANS 1-4 have expressed concern that relying on medication to improve problem behavior in children may, in itself, be disadvantageous. They speculate that the child receiving medication may conclude that the problem is beyond his control and efforts are therefore that he is not responsible for his own behavior.Little is currently known about how hyperactive children feel toward stimulant drug treatment or how best to find out how they feel. Experienced investigators have recognized the questionable value of simply asking the child. 4,5 Interviews combined with pertinent information from the child's close associates would certainly enhance reliability and also permit cross-checking for accuracy of interview information. Our population of hyperactive children, prospectively followed for eight years, provided such additional source material.We interviewed the children and examined their responses in the light of information provided by parents and teachers. Our goals were to find how children feel about being given stimulants for hyperactivity and to study the reliability of interviews of children. MethodsSubject Characteristics . At 52 subjects had been diagnosed hyperactive, were 8 years of age or and had received stimulant medication for at least one year (11 had not been medicated for varying periods of time). Mean age was 11.7 years (SD 2.3); 5 were girls, 47 boys; 5 were black, and 3 of mixed race.

Parental Preferences and Goals Regarding ADHD Treatment

“…Given data that show the unique perspectives of children and adolescents regarding ADHD treatment, research is needed to understand the impact of their preferences and goals on treatment initiation and outcomes. [35][36][37][38][39][40] Although the instrument used in this study was validated as a measure of goals, we did not simultaneously administer a validated measure of goal attainment. Additional work is needed to confirm that a decrease in goal scores on the ADHD PGI definitively represents goal attainment.…”

Evaluation of attitudes towards treatment in adolescents with attention deficit hyperactivity disorder (ADHD)

“…Levels of adherence among ADHD children and adolescents are reportedly very poor, ranging from 35 to 81 %, depending on the methodology applied and the follow-up length [4,8,14,24,34,47,52]. The MTA study showed adherence rates of 63 % at 14 months, though the percentage dropped to less than one-third after 8 years of follow-up [38,41].…”

Peculiaridades del Consentimiento Informado en Salud Mental. Considerando el Caso TDA/H como Ejemplo

“…Un estudio muestra que, aunque rara vez se quejaban a sus médicos, el rechazo era generalizado a la toma del estimulante, y describían su experiencia con expresiones como "me hace triste", "se apodera de mí", "nada me hace reír", "no me deja sentirme como soy", etc. (Sleator, Ullmann y von Neumann, 1982). No parece gustarles el fármaco, expresan sentirse infelices y desean estar como antes de tomarlo (Eichlseder, 1985).…”