Parent-reported symptoms, impairment, helpfulness of treatment, and unmet service needs in a follow-up of outpatient children with attention-deficit/hyperactivity disorder.
BACKGROUND
Limited information exists regarding the associations between impairment, symptoms, helpfulness of treatments, and service needs after initial treatment of children with attention-deficit/hyperactivity disorder (ADHD).


OBJECTIVE
The aims of this study were to examine persistence rates and associations between parent-reported symptoms, impairment, helpfulness of treatments, and service needs in a retrospective follow-up study of children with ADHD.


METHODS
Parents of 214 children with a mean age of 12.6 years (SD = 2.1) who were diagnosed with ADHD at five child and adolescent mental health clinics (CAMHS) completed questionnaires 1-10 years (mean = 3.7 years, SD = 2.2) after baseline assessment. The response rate was 43.4%. A community comparison group (n = 110) was recruited from the same area.


RESULTS
Approximately two-thirds (60.3%) of the sample fulfilled the DSM-IV symptom criteria of ADHD at follow-up, 84.3% were functionally impaired, and most children (84.7%) were on medication. Inattentive and emotional symptoms were the strongest predictors of impairment across impairment areas. Perceived helpfulness of different treatments varied from 71.8-88.7%, and no significant difference was found between the ADHD sub-groups regarding reported helpfulness. 'Adjustment of the school situation' was the most frequent service need, and approximately half of the parents reported needs for care co-ordination. Children fulfilling the symptom criteria of the ADHD Combined sub-group were most impaired and had most service needs.


CONCLUSIONS
At follow-up, children were highly symptomatic and impaired, despite a high rate of persistent medication treatment. The findings underline the need for more tailored treatment and co-ordinated care over time.
a Department of Child and Adolescent Mental Health , Kristiansund Hospital, Møre and Romsdal Health Trust , Norway ;|b Faculty of Medicine , Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Norwegian University of Science and Technology (NTNU) , Trondheim , Norway.
Henrik
H
Sollie
b Faculty of Medicine , Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Norwegian University of Science and Technology (NTNU) , Trondheim , Norway.
Bo
B
Larsson
D000293:Adolescent; D000554:Ambulatory Care Facilities / Q000639:trends; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D008297:Male; D009664:Norway / Q000453:epidemiology; D010045:Outpatients / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
ADHD; children; follow-up; impairment; service needs