Comparison of symptomatic versus functional changes in children and adolescents with ADHD during randomized, double‐blind treatment with psychostimulants, atomoxetine, or placebo
Abstract
Background: This meta‐analysis was designed to determine the relationship between reduction of attention‐deficit/hyperactivity disorder (ADHD) symptoms and improvement in functioning by examining short‐term changes in functional and symptomatic scores in children and adolescents with ADHD. Methods: Search of atomoxetine’s clinical trial database identified four studies involving a symptomatic measure, the ADHD Rating Scale‐IV‐Parent Version:Investigator‐administered and ‐scored (ADHDRS‐IV‐Parent:Inv), and a functional measure, the Life Participation Scale for ADHD (LPS). Results: Correlation analysis revealed a moderate‐to‐strong association between changes in the LPS total versus ADHDRS‐IV‐Parent:Inv total ( r : −.68). The LPS Self‐control subscale showed higher correlations than the Happy/Social subscale with the symptomatic measures. Regression analysis also showed high sensitivity for functional measures to changes in symptom severity. Stratified analysis of mean changes in ADHDRS‐IV‐Parent:Inv scores corresponding to standardized changes in LPS functional scores indicated that a threshold reduction of 16–18 points on the ADHDRS‐IV‐Parent:Inv total score was needed for functional improvements to become evident. Conclusions: Subjects’ symptomatic improvements appear to be reflected in improvements in their social and behavioral function as measured by the LPS. These initial findings warrant verification by replication with other outcome measures.
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Atomoxetine rarely completely normalizes behavior, but symptom improvement is often reflected in gains in social and behavioral function.
“As with stimulant treatment, atomoxetine rarely completely normalizes behavior [87], but symptom improvement is often reflected in gains in social and behavioral function [88].”
From Advances in understanding and treating ADHD (2011) · cites this paper as [88]
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- Authors
- Buitelaar, J. K., Wilens, T. E., Zhang, S., Ning, Y., & Feldman, P. D.
- Affiliations
- Radboud University Nijmegen (NL)
- Harvard University (US)
- Eli Lilly (United States) (US)
- Corresponding author
- Buitelaar, Jan K.
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2009-03
- Volume
- 50
- Issue
- 3
- Pages
- 335-342
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W1963523436
- Cited by
- 41
- References
- 14
- Citations by year
- 2026: 2 · 2025: 1 · 2021: 1 · 2020: 2 · 2019: 2 · 2017: 3 · 2016: 3 · 2015: 8 · 2014: 5 · 2013: 2
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- attention deficit hyperactivity disorder, atomoxetine, psychostimulants, symptom improvement, functional outcome, ADHD Rating Scale-IV, children and adolescents, self-control, social functioning, treatment response
- MeSH terms
- Atomoxetine Hydrochloride, Adolescent, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Double-Blind Method, Female, Humans, Male, Propylamines, Severity of Illness Index, Placebo Effect, Treatment Outcome, Diagnostic and Statistical Manual of Mental Disorders
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