OBJECTIVE: To assess the efficacy of atomoxetine (ATX) and impact of treatment on family functioning in adults with ADHD. METHODS:Adults with attention-deficit/hyperactivity disorder (ADHD) having both a spouse/partner and child were randomized to placebo (n = 234) or ATX (n = 268) for 24 weeks. Attention-deficit/hyperactivity disorder measures included the Conners Adult ADHD Rating Scale total ADHD Symptoms score and Clinical Global Impression-ADHD-Severity. Marital measures included the Dyadic Adjustment Scale and the Family Assessment Measure Dyadic Relationship Scale (FAM III). Parenting measures included the Parenting Stress Index, Alabama Parenting Questionnaire, and Parenting Sense of Competence Scale (PSCS). RESULTS: Improvement was greater with ATX over placebo at 24 weeks on the Conners Adult ADHD Rating Scale (-16.43 vs -8.65; P < 0.001, repeated measures) and Clinical Global Impression (P < 0.001, last observation carried forward). Baseline-to-end point changes in marital and parenting measures were significant but not between treatment groups. Post hoc analyses showed significant interaction of treatment and impairment for the FAM III Task Accomplishment (patient) and Role Performance (patient and spouse) items and PSCS efficacy. Further stratification by sex or presence of a child with ADHD yielded significant interaction and treatment differences for the FAM III Task Accomplishment and the FAM III and Dyadic Adjustment Scale affective expression items, PSCS total score, Alabama Parenting Questionnaire Corporal Punishment, and Parenting Stress Index attachment items. CONCLUSIONS:Atomoxetine demonstrated significant ADHD symptom reduction over 24 weeks. Although both groups demonstrated baseline-to-end point changes on many marital and parenting measure items, there were no treatment differences. Maladaptive behaviors of long-standing ADHD may benefit from both medication and behavioral-psychosocial intervention.
RCT Entities:
OBJECTIVE: To assess the efficacy of atomoxetine (ATX) and impact of treatment on family functioning in adults with ADHD. METHODS: Adults with attention-deficit/hyperactivity disorder (ADHD) having both a spouse/partner and child were randomized to placebo (n = 234) or ATX (n = 268) for 24 weeks. Attention-deficit/hyperactivity disorder measures included the Conners Adult ADHD Rating Scale total ADHD Symptoms score and Clinical Global Impression-ADHD-Severity. Marital measures included the Dyadic Adjustment Scale and the Family Assessment Measure Dyadic Relationship Scale (FAM III). Parenting measures included the Parenting Stress Index, Alabama Parenting Questionnaire, and Parenting Sense of Competence Scale (PSCS). RESULTS: Improvement was greater with ATX over placebo at 24 weeks on the Conners Adult ADHD Rating Scale (-16.43 vs -8.65; P < 0.001, repeated measures) and Clinical Global Impression (P < 0.001, last observation carried forward). Baseline-to-end point changes in marital and parenting measures were significant but not between treatment groups. Post hoc analyses showed significant interaction of treatment and impairment for the FAM III Task Accomplishment (patient) and Role Performance (patient and spouse) items and PSCS efficacy. Further stratification by sex or presence of a child with ADHD yielded significant interaction and treatment differences for the FAM III Task Accomplishment and the FAM III and Dyadic Adjustment Scale affective expression items, PSCS total score, Alabama Parenting Questionnaire Corporal Punishment, and Parenting Stress Index attachment items. CONCLUSIONS:Atomoxetine demonstrated significant ADHD symptom reduction over 24 weeks. Although both groups demonstrated baseline-to-end point changes on many marital and parenting measure items, there were no treatment differences. Maladaptive behaviors of long-standing ADHD may benefit from both medication and behavioral-psychosocial intervention.
Authors: Christopher Hautmann; Manfred Döpfner; Josepha Katzmann; Stephanie Schürmann; Tanja Wolff Metternich-Kaizman; Charlotte Jaite; Viola Kappel; Julia Geissler; Andreas Warnke; Christian Jacob; Klaus Hennighausen; Barbara Haack-Dees; Katja Schneider-Momm; Alexandra Philipsen; Swantje Matthies; Michael Rösler; Wolfgang Retz; Alexander von Gontard; Esther Sobanski; Barbara Alm; Sarah Hohmann; Alexander Häge; Luise Poustka; Michael Colla; Laura Gentschow; Christine M Freitag; Katja Becker; Thomas Jans Journal: BMC Psychiatry Date: 2018-12-13 Impact factor: 3.630
Authors: Lin Li; Zheng Chang; Jiangwei Sun; Andreas Jangmo; Le Zhang; Lars Magnus Andersson; Tamara Werner-Kiechle; Ewa Ahnemark; Brian M D'Onofrio; Henrik Larsson Journal: JAMA Netw Open Date: 2022-04-01