Monitoring medication response in ADHD: what can continuous performance tests tell us?

K Cedergren,M Johnson,J Åsberg Johnels,E Billstedt,S Östlund

doi:10.1007/s00406-021-01319-y

K Cedergren, M Johnson + Show 3 more

Open Access

https://doi.org/10.1007/s00406-021-01319-y

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Abstract

Documenting effectiveness of ADHD medication is essential throughout the course of treatment. A rating scale and a continuous performance test (CPT) with motion tracking were used to study the effect of ADHD medication including compliance during one year. Children (N = 78, age 6–18 years) with ADHD were tested with the QbTest at baseline, visit 1 (1 month after baseline) and visit 5 (12 months after baseline). The ADHD-Rating scale was rated by investigator interview at the same visits. QbTest results and ADHD-RS ratings showed reductions in symptoms on all cardinal parameters of the QbTest and on all ADHD-RS subscales between baseline and 1 month and between baseline and 12 months. There was a weak but significant correlation between the total change scores on the two measures from baseline to 1 month. Eighteen participants dropped out of the study before visit 5; at baseline, these children showed significantly lower results on the inattention parameter of the QbTest, with faster reaction time and lower variation in reaction time, suggesting they suffered less problems with inattention. Both the QbTest and the ADHD-RS showed robust ADHD symptom improvements indicative of medication effect, and the QbTest results might also predict non-compliance of medication. Further research is warranted to increase knowledge about reliable monitoring of long-term medication and compliance.

Highlights

Attention-deficit/hyperactivity disorder (ADHD) is characterized by a persistent pattern of symptoms of inattention and/or impulsivity/hyperactivity that clearly affects development and level of functioning in two or more life domains, such as in school, at home, with friends or in leisure activities [1]
A series of non-parametric Friedman signed-rank tests were conducted to examine how scores from the QbTest and ADHD rating scale changed from baseline to visit 1 and to visit 5
No significant differences in the QbTest results related to gender were found

Summary

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is characterized by a persistent pattern of symptoms of inattention and/or impulsivity/hyperactivity that clearly affects development and level of functioning in two or more life domains, such as in school, at home, with friends or in leisure activities [1]. Very often difficulties associated with ADHD become even more apparent in later school years when higher levels of self-directed attention and executive functioning are required to succeed in school [2]. These difficulties, and failure to achieve, continue to affect occupational, academic and daily level of functioning. Some recent studies show an even higher prevalence [5, 6], making it one of the most common neurodevelopmental disorders. The task of providing time-efficient care without compromising quality is an important challenge for every psychiatric health professional, making brief, administered and objective tests for assessment and follow-up attractive

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Discussion

Conclusion