Aarhus University, Denmark.
University of Nottingham, United Kingdom.
J Am Acad Child Adolesc Psychiatry. 2021 Jun;60(6):734-744.e3. doi: 10.1016/j.jaac.2020.04.014. Epub 2020 Jun 4.
School-age children with attention-deficit/hyperactivity disorder (ADHD) have reduced health-related quality of life (HRQoL), but it is unclear whether this is also true for preschool children. It is unknown whether parent training (PT) improves HRQoL. This study compared HRQoL in preschool children with ADHD with age-matched children from the general population; examined whether PT improves HRQoL; and tested if treatment-related changes in HRQoL were mediated by improvements in ADHD, parent efficacy, and family stress.
Parents of 164 children age 3-7 years with an ADHD diagnosis participated in a randomized controlled trial comparing the New Forest Parenting Programme and treatment as usual. Measures of HRQoL, ADHD, parent efficacy, and family stress were completed at baseline, posttreatment, and 36-week follow-up. Child baseline HRQoL was compared with 2 general population-based reference groups. PT effects were analyzed using linear models and mediation analyses.
Preschoolers with ADHD had lower HRQoL than the reference groups. The New Forest Parenting Programme, but not treatment as usual, was associated with improvement in psychosocial HRQoL at posttreatment (change 2.28, 95% CI [0.78, 3.77]) and at 36-week follow-up (change 2.05, 95% CI [0.56, 3.54]). This difference between treatment arms was not statistically significant. Parent efficacy and family stress scores at posttreatment significantly mediated improvements in HRQoL at 36-week follow-up; ADHD scores at posttreatment did not.
ADHD negatively impacts HRQoL in early childhood. PT for ADHD has the potential to improve HRQoL independently of its effects on ADHD symptoms.
A Controlled Study of Parent Training in the Treatment of ADHD in Young Children (D'SNAPP); http://clinicaltrial.gov/; NCT01684644.
患有注意缺陷多动障碍（ADHD）的学龄儿童的健康相关生活质量（HRQoL）降低，但学龄前儿童是否也是如此尚不清楚。目前尚不清楚父母培训（PT）是否可以提高 HRQoL。本研究比较了 ADHD 学龄前儿童与普通人群中年龄匹配的儿童的 HRQoL；考察了 PT 是否可以提高 HRQoL；并测试了 HRQoL 的治疗相关变化是否通过 ADHD、父母效能和家庭压力的改善来介导。
164 名年龄在 3-7 岁之间患有 ADHD 诊断的儿童的父母参加了一项随机对照试验，比较了新森林育儿计划和常规治疗。在基线、治疗后和 36 周随访时完成了 HRQoL、ADHD、父母效能和家庭压力的测量。比较了儿童的基线 HRQoL 与 2 个基于普通人群的参考组。使用线性模型和中介分析来分析 PT 效果。
与参考组相比，患有 ADHD 的学龄前儿童的 HRQoL 较低。新森林育儿计划，而不是常规治疗，与治疗后（变化 2.28，95%置信区间 [0.78，3.77]）和 36 周随访时（变化 2.05，95%置信区间 [0.56，3.54]）的心理社会 HRQoL 改善相关。治疗组之间的这种差异没有统计学意义。治疗后父母效能和家庭压力评分显著介导了 36 周随访时 HRQoL 的改善；治疗后 ADHD 评分则没有。
ADHD 会对幼儿的 HRQoL 产生负面影响。ADHD 的 PT 有可能在不影响 ADHD 症状的情况下提高 HRQoL。
对幼儿 ADHD 进行父母培训的对照研究（D'SNAPP）；http://clinicaltrial.gov/；NCT01684644。
