Attention-deficit hyperactivity disorder monitoring response to therapy
|
Attention-deficit hyperactivity disorder Microchapters |
|
Differentiating Attention-Deficit Hyperactivity Disorder from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Template:Attention-deficit hyperactivity disorder On the Web |
|
American Roentgen Ray Society Images of Attention-deficit hyperactivity disorder monitoring response to therapy |
|
FDA on Attention-deficit hyperactivity disorder monitoring response to therapy |
|
CDC on Attention-deficit hyperactivity disorder monitoring response to therapy |
|
Attention-deficit hyperactivity disorder monitoring response to therapy in the news |
|
Blogs on Attention-deficit hyperactivity disorder monitoring response to therapy |
|
Directions to Hospitals Treating Attention-deficit hyperactivity disorder |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
Reliable Change Index (RCI) "calculates the pre- and posttest difference thresholds for reliable change that is likely to occur by chance 5% of the time or less."[1] An example is a measure that after successful treatment falls to "2.0 standard deviations above the mean" for the normal population.
In depression, a reduction for 50% in the QIDS-SR16 score has been defined as a response[2].
Monitoring response to treatment
Methods of monitoring treatment for ADHD have been reviewed[3].
The Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) has higher diagnostic accuracy than the WHO Adult ADHD Self-Report Scale (ASRS)[4].
Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS)
One method is the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS). The WRAADDS has been validated in a clinician administered format[5] and a self-administered format[6]. The self-administered version typically reports about 2 points higher than the clinician adminsitered version. The WRAADDS asks 30 questions in 7 domains, each with Cronbach alpha > 0.7:
- Attention Difficulties
- Hyperactivity/Restlessness
- Temper
- Affective Lability
- Emotional Over-Reactivity
- Disorganization
- Impulsivity
Benchmarks for the self-reported version (SR-WRAADDS) are[6]:
- Subjects without ADHD: 8.5 ± 4.6
- Subjects with ADHD: 23.4 ± 4.3
- After treatment, score typically drops by 5 points or effect size (difference / standard deviation) of 0.7
The Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) has higher diagnostic accuracy than the WHO Adult ADHD Self-Report Scale (ASRS)[4]. After treatment, score typically drops by 5 points or effect size (difference / standard deviation) of 0.7 "Follow-up scores falling within 1.0 standard deviation of the normal mean". For example, SR-WRAADD of less than 13.1 "30% reduction in symptoms"
ASRS 18-item symptom checklist
The Adult ADHD Self-Report Scale (ASRS) is labeled as the World Health Organization's (WHO) rating scale for adult ADHD. It has 18 items. It also has a 6-item scale for screening. ASRS-v1.1 is available for download at the Attention Deficit Disorder Association at Harvard's https://www.hcp.med.harvard.edu/ncs/asrs.php[7]
Benchmarks for the ASRS 18-item symptom checklist are 2.0 (SD = 3.2).[8]
- Thus, response might be defined as a value of 5.2 or 8.4 on the Checklist which are 1 and 2 SDs about the mean of 2.0 for the population without ADHD.
- "30% reduction in symptoms" score
Conners Abbreviated Symptom Questionnaire (CAARS)
This scale includes the Conners Adult ADHD Rating Scales (CAARS). It has 66 items. CAARS has four subscales[9]:
- Inattention/memory
- Hyperactivity
- Impulsivity
- Self-concept
The CAARS has been used to measure response to treatment in randomized controlled trials[10].
It is available for download[11].
Affective Lability Scale–Short Form (ALS)
The ALS has 18 items.[12]
Vanderbilt NICHQ
ADHD Rating Scale (for children and adolescents)
For children and adolescents, the ADHD Rating Scale[13] has been used in systematic reviews[14]. In a systematic review, "A clinically meaningful response is generally considered to be improvement of 25% or greater from baseline (a within-group reduction of approximately 10-15 absolute points or a mean difference of approximately 6-7 points between the treatment and placebo groups"[14].
References
- ↑ Jacobson NS, Truax P (1991). "Clinical significance: a statistical approach to defining meaningful change in psychotherapy research". J Consult Clin Psychol. 59 (1): 12–9. doi:10.1037//0022-006x.59.1.12. PMID 2002127.
- ↑ Gaynes BN, Rush AJ, Trivedi MH, Wisniewski SR, Balasubramani GK, McGrath PJ; et al. (2008). "Primary versus specialty care outcomes for depressed outpatients managed with measurement-based care: results from STAR*D". J Gen Intern Med. 23 (5): 551–60. doi:10.1007/s11606-008-0522-3. PMC 2324144. PMID 18247097.
- ↑ Ramsay JR (2017). "Assessment and monitoring of treatment response in adult ADHD patients: current perspectives". Neuropsychiatr Dis Treat. 13: 221–232. doi:10.2147/NDT.S104706. PMC 5291336. PMID 28184164.
- ↑ 4.0 4.1 Brevik EJ, Lundervold AJ, Haavik J, Posserud MB (2020). "Validity and accuracy of the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) symptom checklists in discriminating between adults with and without ADHD". Brain Behav. 10 (6): e01605. doi:10.1002/brb3.1605. PMC 7303368 Check
|pmc=value (help). PMID 32285644 Check|pmid=value (help). - ↑ Marchant BK, Reimherr FW, Robison D, Robison RJ, Wender PH (2013). "Psychometric properties of the Wender-Reimherr Adult Attention Deficit Disorder Scale". Psychol Assess. 25 (3): 942–50. doi:10.1037/a0032797. PMID 23647041.
- ↑ 6.0 6.1 Marchant BK, Reimherr FW, Wender PH, Gift TE (2015). "Psychometric properties of the Self-Report Wender-Reimherr Adult Attention Deficit Disorder Scale". Ann Clin Psychiatry. 27 (4): 267–77, quiz 278-82. PMID 26554368.
- ↑ Attention Deficit Disorder Association. https://add.org/wp-content/uploads/2015/03/adhd-questionnaire-ASRS111.pdf
- ↑ Adler LA, Faraone SV, Sarocco P, Atkins N, Khachatryan A (2019). "Establishing US norms for the Adult ADHD Self-Report Scale (ASRS-v1.1) and characterising symptom burden among adults with self-reported ADHD". Int J Clin Pract. 73 (1): e13260. doi:10.1111/ijcp.13260. PMC 6585602 Check
|pmc=value (help). PMID 30239073. - ↑ Christiansen H, Hirsch O, Philipsen A, Oades RD, Matthies S, Hebebrand J; et al. (2013). "German validation of the Conners adult ADHD rating scale-self-report: confirmation of factor structure in a large sample of participants with ADHD". J Atten Disord. 17 (8): 690–8. doi:10.1177/1087054711435680. PMID 22441889.
- ↑ Philipsen A, Jans T, Graf E, Matthies S, Borel P, Colla M; et al. (2015). "Effects of Group Psychotherapy, Individual Counseling, Methylphenidate, and Placebo in the Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial". JAMA Psychiatry. 72 (12): 1199–210. doi:10.1001/jamapsychiatry.2015.2146. PMID 26536057.
- ↑ Australian Council for Educational Research. Available at https://documents.acer.org/caars-self-l-int1.pdf
- ↑ Weibel S, Micoulaud-Franchi JA, Brandejsky L, Lopez R, Prada P, Nicastro R; et al. (2019). "Psychometric Properties and Factor Structure of the Short Form of the Affective Lability Scale in Adult Patients With ADHD". J Atten Disord. 23 (10): 1079–1089. doi:10.1177/1087054717690808. PMID 28152669.
- ↑ DuPaul GJ, Power TJ, Anastopoulos AD, Reid R. ADHD Rating Scale IV (for Children and Adolescents): Checklists, Norms, and Clinical Interpretation. New York, NY: Guilford Press; 1998
- ↑ 14.0 14.1 Chan E, Fogler JM, Hammerness PG (2016). "Treatment of Attention-Deficit/Hyperactivity Disorder in Adolescents: A Systematic Review". JAMA. 315 (18): 1997–2008. doi:10.1001/jama.2016.5453. PMID 27163988.