Faraone Stephen V, Schachar Russell J, Barkley Russell A, Nullmeier Rick, Sallee F Randy
1 Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University , Syracuse, New York.
2 Department of Psychiatry and Research Institute, The Hospital for Sick Children, University of Toronto , Toronto, Canada .
J Child Adolesc Psychopharmacol. 2017 Oct;27(8):715-722. doi: 10.1089/cap.2016.0164. Epub 2017 Apr 10.
Children with attention-deficit/hyperactivity disorder (ADHD) frequently manifest early morning functional (EMF) impairments before school. We conducted a quantitative research survey to assess the impact of these EMF impairments on the family unit (caregiver, spouse/partner, and siblings).
We developed an online survey questionnaire to collect data from 300 primary caregivers of children with ADHD and 50 primary caregivers of children who did not have ADHD.
Although the ADHD children we surveyed were currently treated with stable doses of stimulants as their primary ADHD medication for at least 3 months, their parents reported high levels of EMF impairments in the child, which had a substantial negative effect on the emotional well-being of parents, on parents' functioning during the early morning routine, and on the level of conflict with siblings. The impact of EMF impairments on family functioning was mediated by the severity of the index child's impairments.
EMF impairments exert a pervasive and significantly negative emotional and functional burden on not only the primary caregiver but also on the spouse/partner and siblings. This work suggests that adequate ADHD symptom control during the early morning period may be an unmet need for school-age children with ADHD being treated with stimulants. More work is needed to confirm this finding and determine the degree to which symptom control at other times of day is also an unmet need.
注意缺陷多动障碍(ADHD)患儿在上学前经常出现清晨功能(EMF)损害。我们进行了一项定量研究调查,以评估这些EMF损害对家庭单位(照顾者、配偶/伴侣和兄弟姐妹)的影响。
我们开发了一份在线调查问卷,以收集300名ADHD患儿的主要照顾者和50名非ADHD患儿的主要照顾者的数据。
尽管我们调查的ADHD患儿目前至少3个月一直以稳定剂量的兴奋剂作为主要的ADHD药物进行治疗,但其父母报告称患儿存在高水平的EMF损害,这对父母的情绪健康、清晨日常活动中的功能以及与兄弟姐妹的冲突程度产生了重大负面影响。EMF损害对家庭功能的影响由索引儿童损害的严重程度介导。
EMF损害不仅对主要照顾者,而且对配偶/伴侣和兄弟姐妹都施加了普遍且显著的负面情绪和功能负担。这项研究表明,对于接受兴奋剂治疗的学龄ADHD患儿,清晨期间充分控制ADHD症状可能是一项未得到满足的需求。需要更多的研究来证实这一发现,并确定一天中其他时间的症状控制未得到满足需求的程度。