Improvements in executive function correlate with enhanced performance and functioning and health-related quality of life: evidence from 2 large, double-blind, randomized, placebo-controlled trials in ADHD.
OBJECTIVE
To assess whether improvement in executive function correlates with perceived improvement in health-related quality of life (HRQOL) in adults with attention-deficit/hyperactivity disorder (ADHD) who are treated with stimulant medication.


METHODS
We collected data on executive function and HRQOL using the Brown Attention-Deficit Disorder Scale (BADDS) and the ADHD Impact Module-Adult (AIM-A) during 2 large, randomized, double-blind, placebo-controlled trials evaluating the use of the triple-bead mixed amphetamine salt (MAS) SPD465 as stimulant pharmacotherapy for ADHD. BADDS and AIM-A data were collected at baseline and at study endpoint, and changes from baseline were assessed. Correlation coefficients for BADDS and AIM-A were calculated at baseline and endpoint for each study.


RESULTS
The change from baseline in BADDS total score was -14.8 ± 24.49 in Study 1 (dose optimization strategy) and -26.1 ± 28.54 in Study 2 (forced-dose titration strategy), demonstrating substantial reported improvement in executive function. In both studies, improvement was reported for all 5 BADDS clusters at study endpoint versus baseline. While improvement was reported for all 6 AIM-A scales at study endpoint versus baseline, the most substantial change from baseline in AIM-A scores over the course of the studies was in Performance and Function (Study 1, +15.2 ± 25.68; Study 2, +26.3 ± 28.17). There was significant correlation of the BADDS total score with the AIM-A Performance and Function scale (Study 1, -0.6723; Study 2, -0.6982), and strong correlations were observed between each of the 5 individual clusters of BADDS and AIM-A performance and function in both studies.


CONCLUSIONS
Reported improvement in executive function correlates with reported improvement in HRQOL as assessed in 2 independent clinical trials in which participants received either placebo or triple-bead MAS for the treatment of ADHD. In particular, there were strong correlations between all 5 individual clusters of BADDS and the AIM-A Performance and Function scale.
Brown
Thomas E
TE
Department of Psychiatry, Yale University School of Medicine, Yale Clinic for Attention and Related Disorders, 1188 Whitney Ave., New Haven, Hamden, CT 06517, USA. tebrownyu@aol.com
Landgraf
Jeanne M
JM
D000293:Adolescent; D000328:Adult; D000662:Amphetamines / Q000008:administration & dosage*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D003692:Delayed-Action Preparations; D003913:Dextroamphetamine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D056344:Executive Function; D006801:Humans; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life
D000662:Amphetamines; D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D003913:Dextroamphetamine