title: Correlation of symptomatic improvements with functional improvements and patient-reported outcomes in adults with attention-deficit/hyperactivity disorder treated with OROS methylphenidate.
abstract: OBJECTIVE
  To evaluate correlations between symptom severity and daily functioning in adults with ADHD.
  
  
  METHODS
  In the 5-week, double-blind LAMDA study, 401 adults with ADHD were randomly assigned to Osmotic-Release Oral System (OROS) methylphenidate (MPH) 18, 36 or 72 mg/day, or placebo. The primary variable - investigator-rated Conners' Adult ADHD Rating Scale (CAARS:O-SV) - has been presented previously. Secondary endpoints included the self-reported version of CAARS (CAARS-S:S) and Clinical Global Impression - Severity (CGI-S). Daily functioning and quality of life were assessed using the Sheehan Disability Scale (SDS) and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Relationships between symptom and functional outcomes were evaluated in post-hoc Pearson partial correlation, multivariate regression and mediator analyses.
  
  
  RESULTS
  Improvements in CAARS-S:S, CGI-S and SDS scores were significantly greater in each OROS MPH arm versus placebo (P < 0.01 for all comparisons). Correlations between symptom and functioning scores were significant for all comparisons (P < 0.0001). In regression analyses, CAARS Hyperactivity/Impulsivity subscale and CGI-S were correlated with SDS (P < 0.05). CAARS Inattention was correlated with the SDS Family Life domain (P < 0.05). In a mediator analysis, the impact of treatment on SDS scores was fully mediated by improvement in CAARS:O-SV score.
  
  
  CONCLUSIONS
  OROS MPH 18-72 mg/day was associated with significant improvements in ADHD symptoms, which correlated with improved daily functioning and health-related quality of life.
authors.affiliation: Saarland University Hospital, Neurocentre, Homburg/Saar, Germany. michael.roesler@uks.eu
authors.forename: Michael
authors.initials: M
authors.lastname: Rösler
authors.forename: Ylva
authors.initials: Y
authors.lastname: Ginsberg
authors.forename: Torben
authors.initials: T
authors.lastname: Arngrim
authors.forename: Marios
authors.initials: M
authors.lastname: Adamou
authors.forename: Asko
authors.initials: A
authors.lastname: Niemelä
authors.forename: Joachim
authors.initials: J
authors.lastname: Dejonkheere
authors.forename: Joop
authors.initials: J
authors.lastname: van Oene
authors.forename: Barbara
authors.initials: B
authors.lastname: Schäuble
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D009995:Osmosis; D011788:Quality of Life; D012044:Regression Analysis; D057566:Self Report; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D008774:Methylphenidate