Impact of attention-deficit/hyperactivity disorder on the patient and family: results from a European survey

Abstract

Background: Children with attention-deficit/hyperactivity disorder (ADHD) often experience problems with education, interaction with others and emotional disturbances. Families of ADHD children also suffer a significant burden, in terms of strain on relationships and reduced work productivity. This parent survey assessed daily life for children with ADHD and their families.

Method: This pan-European survey involved the completion of an on-line questionnaire by parents of children (6-18 years) with ADHD (ADHD sample) and without ADHD (normative population sample). Parents were questioned about the impact of their child's ADHD on everyday activities, general behaviour and family relationships.

Results: The ADHD sample comprised 910 parents and the normative population sample 995 parents. 62% of ADHD children were not currently receiving medication; 15% were receiving 6-8 hour stimulant medication and 23% 12-hour stimulant medication. Compared with the normative population sample, parents reported that ADHD children consistently displayed more demanding, noisy, disruptive, disorganised and impulsive behaviour. Significantly more parents reported that ADHD children experienced challenges throughout the day, from morning until bedtime, compared with the normative population sample. Parents reported that children with ADHD receiving 12-hour stimulant medication experienced fewer challenges during early afternoon and late afternoon/early evening than children receiving 6-8 hour stimulant medication; by late evening and bedtime however, this difference was not apparent. ADHD was reported to impact most significantly on activities such as homework, family routines and playing with other children. All relationships between ADHD children and others were also negatively affected, especially those between parent and child (72% of respondents). Parents reported that more children with ADHD experienced a personal injury in the preceding 12 months, including those requiring the attention of healthcare professionals. Although 68% of parents were satisfied with their child's current treatment, 35-40% stated that their child's ADHD symptoms needed to be more effectively treated during the afternoon and evening.

Conclusion: This parent survey highlights the breadth of problems experienced by ADHD children and the impact throughout the day on both activities and relationships. Therefore, there is a need for treatment approaches that take into account the 24-hour impact of the disorder and include all-day coverage with effective medication.

Figure 1

Flow chart of survey design. ADHD = attention-deficit/hyperactivity disorder.

Figure 2

Types of behaviour exhibited by children with ADHD compared to children without ADHD. Baseline: all qualified respondents (ADHD survey, n = 910; normative population survey, n = 995). *p = 0.0001, non-medicated children with ADHD versus children without ADHD. ^†p = 0.0001, children without ADHD versus non-medicated children with ADHD.

Figure 3

Times of the day children with ADHD find challenging compared to children without ADHD. Baseline: all qualified respondents (ADHD survey, n = 910; normative population survey, n = 995). ADHD = attention-deficit/hyperactivity disorder. *p < 0.05, non-medicated children with ADHD versus children without ADHD. ^†p < 0.05, non-medicated children with ADHD versus 6–8 hours stimulant medication. ^‡p < 0.05, non-medicated children with ADHD versus 12-hour stimulant medication. ^§p < 0.05, 6–8 hour stimulant medication versus children without ADHD. ^¶p < 0.05, 6–8 hour stimulant medication versus non-medicated children with ADHD. **p < 0.05, 6–8 hour stimulant medication versus 12-hour stimulant medication. ^††p < 0.05, 12-hour stimulant medication versus children without ADHD. ^‡‡p < 0.05, 12-hour stimulant medication versus non-medicated children with ADHD. ^§§p < 0.05, 12-hour stimulant medication versus 6–8 hour stimulant medication.

Figure 4

Times of day activities are affected in children with ADHD compared to children without ADHD. Baseline: all qualified respondents (ADHD survey, n = 910; normative population survey, n = 995). *p < 0.05, non-medicated children with ADHD versus children without ADHD. ^†p < 0.05, children without ADHD versus non-medicated children with ADHD. ADHD = attention-deficit/hyperactivity disorder.

Figure 5

Times of day certain behaviours are exhibited by ADHD children compared to children without ADHD. Baseline: all qualified respondents (ADHD survey, n = 910; normative population survey, n = 995). *p < 0.05, non-medicated children with ADHD versus children without ADHD. ^†p < 0.05, children without ADHD versus non-medicated children with ADHD. ADHD = attention-deficit/hyperactivity disorder.

Figure 6

Mean number of personal injuries in children with and without ADHD over the last 12 months. Baseline: all qualified respondents (ADHD survey, n = 910; normative population survey, n = 995). *p < 0.05, 12-hour stimulant medication versus 6–8 hour stimulant medication.**p < 0.05, 6–8 hour stimulant medication versus children without ADHD. ^†p < 0.05, 6–8 hour stimulant medication versus children without ADHD. ^†† p < 0.05, non-medicated children with ADHD versus children without ADHD. ^§p < 0.05, non-medicated children with ADHD versus children without ADHD.