부산대학교 도서관

Objective Attention deficit hyperactivity disorder (ADHD) is one of the neurobehavioral disorders that begins in early childhood and adversely affect the functions of daily life in many ways. Symptoms and functional decline created by ADHD are interrelated but different concepts. In diagnosis and treatment it is recommended to evaluate the functional impairments as well as symptoms. In follow-up studies of ADHD treatment, the scales that measure symptom severity and number generally evaluate treatment response rates, but the scales which measure functional impairment have not been used yet. In this study, it is aimed to evaluate the level of functional impairment in children and adolescents diagnosed with ADHD by using Weiss Functional Impairment Rating Scale - Parent Report (WFIRS-P) after a one-year treatment and follow-up and to investigate the factors, which play role in improvement of functional impairments. Method: 249 children and adolescents from 1st to 8th classes, who applied to the clinic between September 2011 and June 2012, were recruited. Those children and adolescents were diagnosed for the first time with ADHD by Clinical interview based on DSM-IV criteria and the Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version-Turkish Version (SADS-PL-T). Sociodemographic characteristics were evaluated by using a sociodemographic questionnaire that was prepared by the researchers. WFIRS-P and the clinical global impression scale (CGI) were executed by their parents. At the end of one year follow-up 54 children and adolescents, who regularly continued to interviews and drug treatment are determined. Those children and adolescents were evaluated again with WFIRS-P and CGI applied by researchers. Rates of improvement in functional impairments, treatment options playing role in improvement and demographic characteristics are compared with the initial data by using statistical methods. Results: Between 54 children regularly continued to treatment and 195 children who did not continue, there were no significant difference found in terms of age, gender, in WFIRS-P and CGI total and subscale scores. Children's who are treated regularly subtype distribution of diagnosis %87 combined, %11,1 attention deficit, %1,9 hyperactive impulsive type. Children who did not continue to follow up are found %74 to be combined, %17,9 attention deficit, %7,2 hyperactive impulsive type. Children who continued to treatment are %75.9 psychostimulant, 14.8% of atomoxetine, 9.3% of psychostimulant + atomoxetine treatment. CGI average scores, WFIRS-P family, school, social functioning and life quality and the total score's average in children who continued to treatment found statistically significant improvement from baseline. After one year treatment there is significant improvement identified especially in school and social functioning. 54 children's who are treated regularly beginning CGI average score found 4,11Keywords:±0,63 and the level of significantly discomfort. After these children's one year treatment CGI improvement average score found 1,83±0,72 and it's improvement degree found very good/very very good improved. There was significant correlation found between the rates of WFIRS-P improvement scores after treatment with drug groups; WFIRS-P school, social functioning and life quality scores higher with the psychostimulant treatment, we also observed WFIR-S family and social functioning scores higher with the group of using psychostimulant and atomoxetin combination. Conclusion ADHD's regular monitoring with versatile treatment programs provides a significant improvement in symptom severity as well as functioning. In addition to the symptoms of the ADHD, in diagnosis and treatment of the ADHD, the evaluation of the functional impairment and quality of life concepts is thought to be important in dealing with ADHD as a whole. [ABSTRACT FROM AUTHOR]