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Assessing Treatment Outcomes in Attention-Deficit/Hyperactivity Disorder: A Narrative Review

Jeffery N. Epstein, PhD; and Margaret D. Weiss, MD, PhD, FRCP(C)


Objective: To review measures used to assess treatment response in patients with attention-deficit/hyperactivity disorder (ADHD) across the life span.

Data Sources: Keyword searches of English-language articles in the PubMed database up to and including the May 4, 2011, index date were performed with the search strings (1) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (outcome assessment [MeSH] OR adaptation of life skills OR executive function [MeSH]) and (2) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (function OR functioning OR quality of life [MeSH]).

Study Selection: Articles found through this search were then selected based on relevance to the topic area; no specific quality criteria were applied.

Data Extraction: Narrative review.

Results: The vast majority of studies assessing ADHD treatments have measured treatment response using ADHD symptom measures. Additional domains relevant for assessing treatment response among children and adults with ADHD include functional impairment, quality of life, adaptive life skills, and executive function. Validated rating scales exist for assessing these additional domains, but there has been minimal research evaluating the sensitivity of these instruments for detecting treatment response in pediatric and adult samples.

Conclusions: Assessment of treatment outcomes in ADHD should move beyond symptom assessment to incorporate measures of functioning, quality of life, adaptive skills, and executive function, especially when assessing long-term treatment response. The authors recommend a potential battery and schedule of measures that could be used to more comprehensively assess treatment response in patients with ADHD.

Prim Care Companion CNS Disord 2012;14(6):doi:10.4088/PCC.11r01336

Submitted: December 19, 2011; accepted May 11, 2012.

Published online: November 29, 2012.

Corresponding author: Jeffery N. Epstein, PhD, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, ML-10006, Cincinnati, OH 45229-3039 (