Improvement in global psychopathology increases quality of life during treatment of ADHD with atomoxetine or stimulants.

To evaluate what determines the increase in quality of life during treatment for ADHD: improvement in core ADHD symptoms or improvement in global psychopathology ratings. A prospective follow-up of ADHD patients in one community clinic. Standardized evaluation and outcome measures were used, including the Mini International Neuropsychiatric Interview, Child Symptom Inventory, 18 item ADHD rating scale, and the Health and Life Functioning Scale. 75 patients between the ages of 6 and 12 were treated with atomoxetine or stimulants with a stable dose for 10 months. At end point, there were modest improvements in ADHD symptoms, global psychopathology, level of functioning and quality of life. The improvement in quality of life was driven by a decrease in global psychopathology, not by a decrease in ADHD symptoms. The treatment for ADHD may need to be broadened beyond the core symptoms. A chronic disease management model may well be applicable.