Anne‐Mette Lange

Costing Adult Attention Deficit Hyperactivity Disorder: Impact on the Individual and Society

The rapid increase in recent years in the number of children and adults accessing care for ADHD (Attention Deficit Hyperactivity Disorder), raises a number of questions. It is unclear whether the increase is due to an increased public and professional recognition and awareness of ADHD as a debilitating human condition or to an actual increase in the incidence of individuals suffering from ADHD. Depending on the reasons behind the increased burden on services, and whether more effective treatments can be found, the future costs to society could be enormous. The study presented in this book estimates the private and social costs of ADHD. The key focus of this book is to study the costs related to individuals with ADHD who have not been diagnosed and who have not received treatment. In this respect, the study makes a unique contribution to scientific knowledge by investigating the cost of untreated ADHD. The study investigates the extent to which individuals with undiagnosed ADHD in childhood fare differently compared to otherwise similar individuals without ADHD. A long list of important parameters in an individuals life, e.g. educational attainment, occupational status, income, family situation, criminal record, health is examined. The results of the study provide not just cost estimates of ADHD; per se, but also create a point of reference which will be highly relevant for the evaluation of any future treatment for ADHD. The clear picture emerging from this study is that ADHD is associated with considerable private and social costs, reflecting that Adults with ADHD exhibit weak performance across all applied measures. These findings remain even when adults with ADHD are compared to a control group of their own siblings Even though the study is performed for Denmark it is argued that generalizability of the established results beyond Denmark is valid. Contributors to this volume - Torben Tranaes Anders Sorensen

The Effectiveness of Parent Training as a Treatment for Preschool Attention-Deficit/Hyperactivity Disorder: Study Protocol for a Randomized Controlled, Multicenter Trial of the New Forest Parenting Program in Everyday Clinical Practice

Background Parent training is recommended as the first-line treatment for attention-deficit/hyperactivity disorder (ADHD) in preschool children. The New Forest Parenting Programme (NFPP) is an evidence-based parenting program developed specifically to target preschool ADHD. Objective The objective of this trial is to investigate whether the NFPP can be effectively delivered for children referred through official community pathways in everyday clinical practice. Methods A multicenter randomized controlled parallel arm trial design is employed. There are two treatment arms, NFPP and treatment as usual. NFPP consists of eight individually delivered parenting sessions, where the child attends during three of the sessions. Outcomes are examined at three time points (T1, T2, T3): T1 (baseline), T2 (week 12, post intervention), and T3 (6 month follow/up). 140 children between the ages of 3-7, with a clinical diagnosis of ADHD, informed by the Development and Well Being Assessment, and recruited from three child and adolescent psychiatry departments in Denmark will take part. Randomization is on a 1:1 basis, stratified for age and gender. Results The primary endpoint is change in ADHD symptoms as measured by the Preschool ADHD-Rating Scale (ADHD-RS) by T2. Secondary outcome measures include: effects on this measure at T3 and T2 and T3 measures of teacher reported Preschool ADHD-RS scores, parent and teacher rated scores on the Strength & Difficulties Questionnaire, direct observation of ADHD behaviors during Child’s Solo Play, observation of parent-child interaction, parent sense of competence, and family stress. Results will be reported using the standards set out in the Consolidated Standards of Reporting Trials Statement for Randomized Controlled Trials of nonpharmacological treatments. Conclusions The trial will provide evidence as to whether NFPP is a more effective treatment for preschool ADHD than the treatment usually offered in everyday clinical practice. Trial Registration ClinicalTrials.gov NCT01684644; https://clinicaltrials.gov/ct2/show/NCT01684644?term= NCT01684644&rank=1 (Archived by WebCite at http://www.webcitation/6eOOAe8Qe)