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Objective: Attention deficit hyperactivity disorder (ADHD) is one of the neurobehavioral disorders that begins in early childhood and adversely affect the functions of daily life in many ways . Symptoms and functional decline created by ADHD are interrelated but different. In diagnosis and treatment it is recommended to evaluate the functional impairments as well as symptoms. . In follow-up studies of ADHD treatment, the scales that measure symptom severity and number generally evaluate treatment response rates, but the scales, which measure functional impairment, have not been used yet. In this study, it is aimed to evaluate the level of functional impairment in children and adolescents with diagnosed ADHD by using Weiss Functional Impairment Rating Scale – Parent Report (WFIRS-P) after a one-year treatment and follow-up and to investigate the factors, which play role in improvement of functional impairments.
Method: Two hundred and forty-nine children and adolescents from 1st to 8th classes, who applied to the clinic between September 2011 and June 2012, were recruited.. Those patients were diagnosed for the first time as ADHD by Clinical interview based on DSM-IV criteria and the Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version-Turkish Version (SADS-PL-T). Sociodemographic characteristics were evaluated by using a sociodemographic questionnaire that was prepared by the researchers. WFIRS-P and the clinical global impression scale (CGI) were administered to the parents. By the end of one year follow-up 54 children and adolescents, who were regular on interviews and drug treatment were identified. Those children and adolescents were evaluated again with WFIRS-P and CGI applied by researchers. Rates of improvement in functional impairments, treatment options playing role in improvement and demographic characteristics are compared with the initial data by using statistical methods.
Results: Between regularly followed up 54 children and 195 children who were not regular, there were no significant difference found in terms of age, gender, in WFIRS-P and CGI total and subscale scores. Children’s that were followed up regularly had subtype distribution of diagnosis as %87 combined, %11 attention deficit, %1,9 hyperactive impulsive type. %74 of children who did not continue to follow up were found to be combined, %17,9 attention deficit, %7,2 hyperactive impulsive type. 75.9% of children who continued to follow up were given psychostimulant (14.8% of atomoxetine, 9.3% of psychostimulant + atomoxetine) treatment. CGI average scores, WFIRS-P family, school, life skills and social interaction and the total score’s average in children who continued to follow up revealed a statistically significant improvement from baseline. Among the subtypes of ADHD there was no significant difference found in terms of improvement in CGI and WFIRS-P scores. In the same way, drugs groups in terms of improvement in CGI and WFIRS-P scores were not significantly different.
Conclusion: Regular monitoring in ADHD with versatile treatment programs provides a significant improvement in symptom severity as well as functioning. In addition to the symptoms of the ADHD, diagnosis and treatment of the ADHD, the evaluation of the functional impairment and quality of life concepts is thought to be important in dealing with ADHD as a whole.