Treatment Duration is Associated with Functioning and Prognosis in Children with Attention Deficit Hyperactivity Disorder

Ercan, Eyyup Sabri; Köse, Sezen; Kutlu, Ayşe; Akyol, Oznur; Durak, Sibel; Aydın, Cahide

doi:10.5455/bcp.20120412021635

Cited by 5 publications

(14 citation statements)

References 52 publications

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“…Small short-term improvements in quality of life (3) [334][335][336] Reduced risk of various outcomes (2) 350,351 Lack of methodologically sound research on which to base decisions (1) 352 Longer treatment duration indicated better outcomes for various domains (1) 353 No long-term treatment effect for various functioning outcomes (3) [354][355][356] Abbreviations empowerment for those involved. It provided a biomedical explanation for experienced problems, supporting a sense of legitimacy 57,214-217 accompanied by understanding and sympathy [215][216][217][218][219][220][221][222] as well as decreased guilt, blame, and anger.…”

Section: Quality Of Life (4)mentioning

confidence: 99%

Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

et al. 2021

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IMPORTANCE Reported increases in attention-deficit/hyperactivity disorder (ADHD) diagnoses are accompanied by growing debate about the underlying factors. Although overdiagnosis is often suggested, no comprehensive evaluation of evidence for or against overdiagnosis has ever been undertaken and is urgently needed to enable evidence-based, patient-centered diagnosis and treatment of ADHD in contemporary health services. OBJECTIVE To systematically identify, appraise, and synthesize the evidence on overdiagnosis of ADHD in children and adolescents using a published 5-question framework for detecting overdiagnosis in noncancer conditions. EVIDENCE REVIEW This systematic scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews and Joanna Briggs Methodology, including the PRISMA-ScR Checklist. MEDLINE, Embase, PsychINFO, and the Cochrane Library databases were searched for studies published in English between January 1, 1979, and August 21, 2020. Studies of children and adolescents (aged Յ18 years) with ADHD that focused on overdiagnosis plus studies that could be mapped to 1 or more framework question were included.Two researchers independently reviewed all abstracts and full-text articles, and all included studies were assessed for quality. FINDINGS Of the 12 267 potentially relevant studies retrieved, 334 (2.7%) were included. Of the 334 studies, 61 (18.3%) were secondary and 273 (81.7%) were primary research articles. Substantial evidence of a reservoir of ADHD was found in 104 studies, providing a potential for diagnoses to increase (question 1). Evidence that actual ADHD diagnosis had increased was found in 45 studies (question 2). Twenty-five studies showed that these additional cases may be on the milder end of the ADHD spectrum (question 3), and 83 studies showed that pharmacological treatment of ADHD was increasing (question 4). A total of 151 studies reported on outcomes of diagnosis and pharmacological treatment (question 5). However, only 5 studies evaluated the critical issue of benefits and harms among the additional, milder cases. These studies supported a hypothesis of diminishing returns in which the harms may outweigh the benefits for youths with milder symptoms. CONCLUSIONS AND RELEVANCEThis review found evidence of ADHD overdiagnosis and overtreatment in children and adolescents. Evidence gaps remain and future research is needed, in particular research on the long-term benefits and harms of diagnosing and treating ADHD in youths with milder symptoms; therefore, practitioners should be mindful of these knowledge gaps, especially when identifying these individuals and to ensure safe and equitable practice and policy.

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Section: Quality Of Life (4)mentioning

confidence: 99%

Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

et al. 2021

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“…The authors defined the study design (cohort study) 14 in only one article. Thus, we classified the others as cohort study ( n = 3), 12,13,15,16 cross‐sectional study ( n = 3) 17‐19 and before‐and‐after design study ( n = 2) 20,21 2 summarizes the key information collected, focusing on the results of academic performance.…”

Section: Resultsmentioning

confidence: 99%

“Real‐world” effectiveness of methylphenidate in improving the academic achievement of Attention‐Deficit Hyperactivity Disorder diagnosed students—A systematic review

Faria

Duarte

Ferreira

et al. 2021

Clinical Pharmacy Therapeu

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What is known and Objective Attention‐deficit hyperactivity disorder (ADHD) symptoms usually impairs academic achievement and can trigger the onset of medication. Methylphenidate is a drug widely prescribed to treat ADHD. However, systematic reviews of randomized clinical trials suggest that it does not lead to great improvements in academic performance. Thus, we aimed to evaluate the evidence on the “real‐world” effectiveness of methylphenidate in improving the academic achievement of ADHD students. Methods We conducted a systematic review of observational studies retrieved from five electronic databases, besides a manual search and search in grey literature. Studies evaluating treatment with methylphenidate compared to no treatment or other pharmacological/non‐pharmacological alternatives used in ADHD were included. The risk of bias of the selected studies was assessed using adapted versions of the Newcastle‐Ottawa Scale. Results and Discussion Nine studies (from ten reports) were included in the review: four cohorts, two before‐and‐after designs and three cross‐sectional studies. They involved 12,269 children and adolescents aged 6–18 years. The doses of methylphenidate ranged from 10 to 72 mg/day, and the duration of the treatment from 2.6 months to 4.25 years. Five of these studies concluded that methylphenidate improves academic performance. However, three of the four lowest‐bias risk studies concluded that the drug is ineffective. Five studies assessed the long‐term use of methylphenidate, and four of them concluded that it does not result in better outcomes in the school setting. Most included studies had considerable limitations and significant heterogeneity regarding methodological design and academic performance measurement criteria. What is new and Conclusion Although some studies indicate that the short‐term use of methylphenidate may improve outcomes in the school environment, the available evidence does not support the establishment of adequate conclusions about the real benefits of methylphenidate in the academic improvement of ADHD students.

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“…Several studies found that youth who maintained a consistent regimen of stimulant medication during the study period had lower rates of smoking than youth who discontinued their medication (Ercan et al, 2012;Monuteaux, Spencer, Faraone, Wilson, & Biederman, 2007) or those who were not treated (Whalen, Jamner, Henker, Gehricke, & King, 2003). Further evidence for the importance of continuous treatment in reducing smoking risk is derived from study findings, including those of Lambert's (2005) study described above, indicating that the progression to regular smoking coincides temporally with youths' discontinuation of stimulant treatment (Huss, Poustka, Lehmkuhl, & Lehmkuhl, 2008).…”

Section: Evidence For Decreased Risk Of Smoking Following Stimulant Tmentioning

confidence: 98%

The ADHD–Smoking Comorbidity and Implications for Stimulant Treatment in Children and Adolescents

Schoenfelder¹,

Kollins²

2013

Child and Adolescent Psychopharmacology News

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Treatment Duration is Associated with Functioning and Prognosis in Children with Attention Deficit Hyperactivity Disorder

Cited by 5 publications

References 52 publications

Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

“Real‐world” effectiveness of methylphenidate in improving the academic achievement of Attention‐Deficit Hyperactivity Disorder diagnosed students—A systematic review

The ADHD–Smoking Comorbidity and Implications for Stimulant Treatment in Children and Adolescents

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