title: Worse Quality of Life for Children With Newly Diagnosed Attention-Deficit/Hyperactivity Disorder, Compared With Asthmatic and Healthy Children Effect of melatonin on sleep, behavior, and cognition in ADHD and chronic sleep-onset insomnia. Does resistance training improve the functional capacity and well being of very young anorexic patients? A randomized controlled trial. Disorder-Specific Cognitive-Behavioral Therapy for Separation Anxiety Disorder in Young Children: A Randomized Waiting-List-Controlled Trial Cognitive-behavioral group therapy for youths with anxiety disorders in the community: effectiveness in low and middle income countries. Depression, anxiety and obsessive-compulsive symptoms and quality of life in children with attention-deficit hyperactivity disorder (ADHD) during three-month methylphenidate treatment Effect of aripiprazole 2 to 15 mg/d on health-related quality of life in the treatment of irritability associated with autistic disorder in children: a post hoc analysis of two controlled trials. A long-term open-label safety and effectiveness trial of lisdexamfetamine dimesylate in adolescents with attention-deficit/hyperactivity disorder. Atomoxetine treatment in children and adolescents with attention-deficit hyperactivity disorder: what are the long-term health-related quality-of-life outcomes? Social skills improvement in children with high-functioning autism: a pilot randomized controlled trial Improvement in Global Psychopathology Increases Quality of Life During Treatment of ADHD with Atomoxetine or Stimulants Effect of atomoxetine on quality of life and family burden: results from a randomized, placebo-controlled, double-blind study in children and adolescents with ADHD and comorbid oppositional defiant or conduct disorder Both Atomoxetine and Stimulants Improve Quality of Life in an ADHD Population Treated in a Community Clinic Psychosocial functioning and health-related quality of life in children and adolescents treated with open-label ziprasidone for bipolar mania, schizophrenia, or schizoaffective disorder. Effects of methylphenidate on quality of life in children with both developmental coordination disorder and ADHD. Prospective trial of equine-assisted activities in autism spectrum disorder. Atomoxetine treatment in children and adolescents with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder. Managing sleep problems in school aged children with ADHD: a pilot randomised controlled trial. Randomized controlled pilot study of quetiapine in the treatment of adolescent conduct disorder. Transitioning to OROS® methylphenidate from atomoxetine is effective in children and adolescents with ADHD
abstract: Objective . To evaluate the quality of life ( QOL ) of untreated children with newly diagnosed attention-deficit/hyperactivity disorder ( ADHD ) , compared with asthmatic and healthy children . Methods . This prospect i ve , case-control study included a group of 120 children , 6 to 12 years of age , with newly diagnosed ADHD according to the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition . Subjects were matched according to age , gender , and health care area with 2 control groups , ie , 93 asthmatic children and 120 healthy children . Sociodemographic characteristics and Child Health Question naire scores were collected . Results . The QOL of children with ADHD was rated worse than that of asthmatic or healthy children for most Child Health Question naire domains . The greatest differences were found in behavior , social limitations attributable to physical problems , emotional impact on parents , and family activities . Almost every psychosocial domain was more affected in comparison with asthmatic children and both psychosocial and physical domains in comparison with healthy children . Conclusions . ADHD interferes with the daily lives of children , parents , and families even more than asthma , primarily in areas related to psychosocial functioning , although evidence of impaired physical functioning also emerged . Delays in recognition , assessment , and management of ADHD may affect negatively the QOL of those children OBJECTIVE To investigate the effect of melatonin treatment on sleep , behavior , cognition , and quality of life in children with attention-deficit/hyperactivity disorder ( ADHD ) and chronic sleep onset insomnia . METHOD A total of 105 medication-free children , ages 6 to 12 years , with rigorously diagnosed ADHD and chronic sleep onset insomnia participated in a r and omized , double-blind , placebo-controlled trial using 3 or 6 mg melatonin ( depending on body weight ) , or placebo for 4 weeks . Primary outcome parameters were actigraphy-derived sleep onset , total time asleep , and salivary dim light melatonin onset . RESULTS Sleep onset advanced by 26.9 + /- 47.8 minutes with melatonin and delayed by 10.5 + /- 37.4 minutes with placebo ( p < .0001 ) . There was an advance in dim light melatonin onset of 44.4 + /- 67.9 minutes in melatonin and a delay of 12.8 + /- 60.0 minutes in placebo ( p < .0001 ) . Total time asleep increased with melatonin ( 19.8 + /- 61.9 minutes ) as compared to placebo ( -13.6 + /- 50.6 minutes ; p = .01 ) . There was no significant effect on behavior , cognition , and quality of life , and significant adverse events did not occur . CONCLUSION Melatonin advanced circadian rhythms of sleep-wake and endogenous melatonin and enhanced total time asleep in children with ADHD and chronic sleep onset insomnia ; however , no effect was found on problem behavior , cognitive performance , or quality of life PURPOSE We determined the effects of a 3-month low-moderate-intensity strength training program ( 2 sessions/week ) on functional capacity , muscular strength , body composition , and quality of life ( QOL ) in 22 young ( 12 - 16 yrs ) anorexic out patients . METHODS Patients were r and omly assigned to a training or control group  ( n=11 [ 10 females ] each ) . Training sessions were of low intensity ( loads for large muscle groups ranging between 20%-30 % and 50%-60 % of six repetitions maximum [ 6RM ] at the end of the program ) . We measured functional capacity by the time up and go and the timed up and down stairs tests . Muscular strength was assessed by 6RM measures for seated bench and leg presses . We estimated percent body fat and muscle mass . We assessed patients ' QOL with the Short Form-36 items . RESULTS The intervention was well tolerated and did not have any deleterious effect on patients ' health , and did not induce significant losses in their body mass . The only studied variable for which a significant interaction ( group x time ) effect was found ( p=.009 ) was the 6RM seated lateral row test . CONCLUSIONS Low-moderate-intensity strength training does not seem to add major benefits to conventional psychotherapy and refeeding treatments in young anorexic patients Background : Separation anxiety disorder ( SAD ) is one of the earliest and most common mental disorders in childhood , and a strong predictor of adult psychopathology . Despite significant progress in psychotherapy research on childhood anxiety disorders , no r and omized controlled trial has been conducted with a disorder-specific treatment program for young children suffering from SAD . Methods : Forty-three children ( ages 5–7 ) with SAD and their parents were assigned to either a 16-session disorder-specific SAD treatment program including parent training and classical cognitive-behavioral therapy ( CBT ) components , or to a 12-week waiting list group . Categorical and /or continuous data for anxiety , impairment/distress and quality of life were collected at baseline , after treatment/waiting list condition , and at a 4-week follow-up . Results : Intention-to-treat analyses indicate that 76.19 % of children allocated to the treatment group definitively no longer fulfilled DSM-IV criteria for SAD at follow-up , compared to 13.64 % in the waiting list group . Between 91 and 100 % of children rated themselves or were rated by their father , mother or therapist as very much or much improved on the global success rating immediately after treatment . Results indicated large time by treatment condition interaction effect sizes ( d = 0.98–1.41 ) across informants for reduction of distress/avoidance in separation situations after the test for the treatment condition . Further , parents reported significant improvements in impairment/distress in the child ’s major life domains and the child ’s quality of life . Treatment gains were maintained at the 4-week follow-up assessment . Conclusions : Results indicate the short-term efficacy of a disorder-specific treatment approach for SAD , and are among the first to indicate that CBT programs work with young children BACKGROUND Although cognitive-behavioral therapy ( CBT ) is established as a first line treatment for anxiety disorders in children and adolescents , there is little evidence about the effectiveness of CBT protocol s in cases identified in the community in low and middle income countries ( LaMICs ) . AIMS To evaluate the effectiveness of group CBT protocol for youths with anxiety disorders identified in a community sample in LaMICs . METHOD A total of 14 sessions of group CBT for youths and 2 concurrent sessions for parents based on Kendall 's Coping Cat program were offered . Participants were selected from a cross-sectional community study ; 45 subjects fulfilled inclusion criteria and 28 agreed to participate in the open clinical trial .  Treatment effectiveness was evaluated with st and ard clinical , self- and parent-rated measures of anxiety , depression , externalizing symptoms and quality of life ( QoL ) . RESULTS Twenty youths completed the protocol . All scales showed an improvement of anxiety and reduction in externalizing symptoms over time , with a moderate to large effect size ( d = 0.59 to 2.06 ; p < .05 ) , but not in depressive symptoms or QoL. CONCLUSIONS Consistent with previous evidence , group CBT is effective in treating anxiety disorders in youths . Results encourage further r and omized clinical trials using CBT protocol s adapted and developed to be used in LaMICs The current study was design ed to investigate the changes that occur in depression , anxiety , obsessive — compulsive symptoms and health-related quality of life during methylpheni date ( MPH ) treatment in children with attention-deficit hyperactivity disorder ( ADHD ) . Forty-five treatment naive children with ADHD , aged 8—14 , were assessed based on self , parent and teacher reports at the baseline and at the end of the first and third month of MPH treatment regarding changes in inattention , hyperactivity , impulsivity , depression , anxiety and obsessive — compulsive symptoms . Changes in the quality of life were also noted . Repeated measures of analysis of variance ( ANOVA ) tests with Bonferroni corrections were conducted in order to evaluate the data . Symptoms of inattention , hyperactivity and impulsivity were significantly reduced ( p < 0.017 ) following a three-month MPH treatment . There were significant decreases in depression ( p = 0.004 ) , trait anxiety ( p = 0.000 ) and checking compulsion symptom scores ( p = 0.001 ) . Moreover , parents reported significant improvements in psychosocial ( p = 0.001 ) and total scores ( p = 0.009 ) of quality of life , despite no change in physical health scores ( p > 0.05 ) . Children ’s ratings of quality of life measures showed no significant changes in physical health and psychosocial scores ( p > 0.05 ) , while total scores significantly improved ( p = 0.001 ) after the treatment . Over a three-month MPH treatment , depression , trait anxiety and checking compulsion symptoms decreased and quality of life seemed to improve along with those of inattention , hyperactivity and impulsivity BACKGROUND There are limited published data on the impact of treatment on the health-related quality of life ( HRQOL ) in individuals with autistic disorder . OBJECTIVE The aim of this study was to evaluate the impact of aripiprazole on HRQOL in the treatment of irritability in pediatric patients ( aged 6 - 17 years ) with autistic disorder . METHODS This post hoc analysis assessed data from two 8-week , double-blind , r and omized , placebo-controlled studies that compared the efficacy of aripiprazole ( fixed-dose study , 5 , 10 , and 15 mg/d ; flexible-dose study , 2 - 15 mg/d ) with placebo in the treatment of irritability associated with autistic disorder . HRQOL was assessed at baseline and week 8 using 3 Pediatric Quality of Life Inventory ( PedsQL ™ ) scales . Clinical ly relevant improvement in HRQOL was determined using an accepted distribution-based criterion-1 st and ard error of measurement . RESULTS In total , 316 patients were r and omly assigned to receive treatment with aripiprazole ( fixed-dose study , 166 ; flexible-dose study , 47 ) or placebo ( fixed-dose study , 52 ; flexible-dose study , 51 ) . Aripiprazole was associated with significantly greater improvement  than placebo in PedsQL combined-scales total score ( difference , 7.8 ; 95 % CI , 3.8 - 11.8 ; P < 0.001 ) and in 3 PedsQL scale scores ( differences [ 95 % CI ] : Emotional Functioning , 7.8 [ 3.4 - 12.2 ] ; Social Functioning , 6.2 [ 0.7 - 11.8 ] ; Cognitive Functioning , 9.3 [ 3.8 - 14.9 ] ; all , P < 0.05 ) . Patients who received aripiprazole were significantly more likely than those who received placebo to have a clinical ly meaningful improvement on the combined-scales total score ( odds ratio [ OR ] = 1.9 ; 95 % CI , 1.0 - 3.3 ; P < 0.05 ) , Emotional Functioning scale ( OR = 2.2 ; 95 % CI , 1.2 - 4.0 ; P < 0.05 ) and Social Functioning scale ( OR = 2.2 ; 95 % CI , 1.2 - 4.1 ; P < 0.05 ) , and were significantly less likely to experience deterioration ( OR : 0.3 , 95 % CI : 0.1 - 0.8 ; P < 0.05 ) when " Stable " was used as the reference group . CONCLUSIONS The findings from the present post hoc analysis suggest that aripiprazole was associated with improved HRQOL , as assessed using 3 PedsQL scales , in pediatric patients with irritability associated with autistic disorder OBJECTIVE Information on psychostimulant treatment in long-term studies for attention-deficit/hyperactivity disorder ( ADHD ) in adolescents is limited . This study aim ed to assess the safety and effectiveness of lisdexamfetamine dimesylate ( LDX ) over 52 weeks in adolescents with ADHD . METHODS This open-label multicenter study enrolled eligible participants after their participation in a r and omized , double-blind , placebo-controlled 4 week trial in adolescents with ADHD . Following a 4 week dose-optimization phase , participants were maintained on treatment for up to ∼48 weeks on an optimal dose . Safety assessment s included treatment-emergent adverse events ( TEAEs ) , vital signs , laboratory findings , and electrocardiograms . Effectiveness measures included the ADHD Rating Scale IV ( ADHD-RS-IV ; primary ) and Clinical Global Impressions-Improvement ( CGI-I ) . The Youth Quality of Life- Research Version ( YQOL-R ) was also included in this study ; raw scores are transformed to a 0 - 100 point scale . RESULTS Of 269 enrolled ( from the antecedent study ) , 265 ( 98.5 % ) were in the safety population and effectiveness population . Common TEAEs ( ≥5 % ) with LDX included upper respiratory tract infection ( 21.9 % ) , decreased appetite ( 21.1 % ) , headache ( 20.8 % ) , decreased weight ( 16.2 % ) , irritability ( 12.5 % ) , insomnia ( 12.1 % ) , nasopharyngitis ( 7.2 % ) , influenza ( 6.8 % ) , dizziness ( 5.3 % ) , and dry mouth ( 5.3 % ) . At end point , for all LDX doses in the overall safety population , mean ( SD ) increase from baseline in systolic blood pressure was 2.3 ( 10.53 ) mm Hg , diastolic blood pressure was 2.5 ( 8.37 ) mm Hg , and pulse rate was 6.3 ( 12.74 ) bpm . No clinical ly meaningful electrocardiogram or vital sign changes were observed . At end point with LDX treatment , the ADHD-RS-IV mean ( SD ) total score change from antecedent study baseline was -26.2 ( 9.75 ) ( p<0.001 ) ; 87.2 % of participants were improved ( CGI-I=1 or 2 ) . Baseline ( antecedent study ) mean ( SD ) YQOL-R perceptual total score was 79.8 ( 11.28 ) and increased by 3.9 ( 9.73 ) at end point ( p<0.001 ) . CONCLUSIONS LDX demonstrated a long-term safety profile similar to that of other long-acting psychostimulants and was effective , as indicated by improvements in ADHD symptoms and participant-perceived YQOL , in adolescents with ADHD . CLINICAL TRIAL REGISTRATION NCT00764868 , http://www . clinical trials.gov/ct2/show/NCT00764868?term=SPD489-306&rank=1 OBJECTIVE Numerous investigations have examined the efficacy of pharmacological treatment for attention-deficit/hyperactivity disorder ( ADHD ) in children . However , relatively few studies have addressed the impact of treatment on long-term subjective , psychosocial outcomes , such as health-related quality of life ( HRQL ) . This study examines the long-term effects of pharmacological treatment with atomoxetine on HRQL in children and adolescents with ADHD . METHODS Participants included 6- to 17-year-old children and adolescents ( n = 912 ) with ADHD enrolled in a 24-month , multicenter , open-label trial of atomoxetine . Outcomes included clinician ratings of ADHD , parent ratings of ADHD , and a widely used measure of HRQL ( The Child Health Question naire ( CHQ ) ) . Treatment response rates were calculated based on a CHQ improvement of at least 1 st and ard error of measurement . RESULTS Significant improvements in HRQL were found following both acute and long-term treatment for psychosocial but not physical health . Of participants who completed treatment ( n = 312 or 34.2 % of those enrolled ) , 81 % responded to acute treatment and 78 % responded to long-term treatment . Improvements noted after acute treatment were maintained during long-term treatment with the majority of participants ( 86 % ) continuing to respond to treatment . CONCLUSIONS Atomoxetine is associated with improvements in HRQL , and the improvements are generally stable over time High-functioning autism ( HFA ) is characterized by persistent impairment in social interaction despite the absence of mental retardation . Although an increasing number of group-based programs for the improvement of social skills have been described , r and omized controlled trials are needed to evaluate their efficacy . To compare the effect of a Social Skills Training Group-based Program ( SST-GP ) and a Leisure Activities Group-based Program ( LA-GP ) on the perception of facial emotions and quality of life ( QoL ) in young people with HFA . Eligible patients were children and adolescents with HFA . Participants were r and omized to the SST or LA group . The primary outcome was defined as an improvement of 2 points in error rates for facial emotion labeling ( DANVA2 ) from baseline . After the 6-month training period , the SST Group made fewer errors in labeling anger on adult faces , whereas error rates in the LA Group remained stable . Progress in the ability to recognize anger in the SST Group was due to better recognition of low intensity stimuli on adult faces . QoL increased in the SST Group in the dimension of school environment , as a marker of the transfer of skills acquired in the treatment setting to their use in the community . The SST-GP had higher efficacy than the LA-GP . Data justify replication using larger sample To evaluate what determines the increase in quality of life during treatment for ADHD : improvement in core ADHD symptoms or improvement in global psychopathology ratings . A prospect i ve follow-up of ADHD patients in one community clinic . St and ardized evaluation and outcome measures were used , including the Mini International Neuropsychiatric Interview , Child Symptom Inventory , 18 item ADHD rating scale , and the Health and Life Functioning Scale .  75 patients between the ages of 6 and 12 were treated with atomoxetine or stimulants with a stable dose for 10 months . At end point , there were modest improvements in ADHD symptoms , global psychopathology , level of functioning and quality of life . The improvement in quality of life was driven by a decrease in global psychopathology , not by a decrease in ADHD symptoms . The treatment for ADHD may need to be broadened beyond the core symptoms . A chronic disease management model may well be applicable Purpose To evaluate the effect of atomoxetine on quality of life ( QoL ) and family burden in children and adolescents with attention deficit/hyperactivity disorder ( ADHD ) and comorbid oppositional defiant ( ODD ) or conduct disorder ( CD ) . Methods This secondary analysis was based on a r and omized , double-blind , 9-week study of atomoxetine ( target dose 1.2 mg/kg body weight ) versus placebo . The study included 180 patients ( atomoxetine 121 , placebo 59 ) , aged 6–17 years .  QoL was measured using the KINDL-R question naire . The total score encompasses six dimensions ( or subscales ) measuring QoL in terms of “ physical well-being ” , “ emotional well-being ” , “ self-esteem ” , “ friends ” , “ family ” , and “ school ” . Family burden of illness was measured using the FaBel question naire . Results With atomoxetine , the KINDL-R total score improved significantly ( P = 0.021 ) more than with placebo . This improvement also applied to the subscales except for “ physical well-being ” ( opposite effect ) and “ school ” ( no effect ) . No significant treatment group differences were seen on the FaBel question naire . No differences were found between the fast and slow titration groups in terms of ADHD , ODD , and disruptive behavior severity . Furthermore , no such differences were observed for QoL and family burden . Conclusions This study suggests positive effects of atomoxetine on quality of life , as measured by the KINDL-R scores on emotional well-being , self-esteem , friends and family , in children and adolescents with ADHD and comorbid ODD/CD . No significant treatment effects were seen on family burden , as measured by FaBel total score Objective To evaluate change in quality of life in a community clinic ADHD population treated with  atomoxetine or stimulants . No direct comparisons between atomoxetine and stimulants to improve quality of life in ADHD are available . Methods A prospect i ve , nonr and omized comparison between ADHD patients treated with atomoxetine or stimulants in one clinic . Structured diagnostic assessment tools and a specific quality of life measure were used . Results 84 patients ( atomoxetine n = 39/stimulants n = 45 ) , between the ages of 5 and 18 , were treated for approximately 8 months . At end point , there were no significant differences in improvements of quality of life between the two groups . Age , participation in psychotherapy , and parental disability were not correlated with quality of life changes . Patients with lower baseline scores improved most . Conclusions Both atomoxetine and stimulants led to a modest increase in quality of life in this community clinic ADHD population OBJECTIVE The aim of this study was to examine global functioning , health-related quality of life ( HRQOL ) , and clinical outcome in children and adolescents with bipolar I disorder , schizophrenia , or schizoaffective disorder following ziprasidone treatment . METHODS Sixty-three subjects ( aged 10 - 17 years ) received open-label ziprasidone  , titrated from 10 to 40 mg twice a day ( b.i.d . ) ( low-dose group ) or from 20 to 80 mg b.i.d . ( high-dose group ) ; fixed doses were used until week 3 , followed by flexible doses for 6 months . The Children 's Global Assessment Scale ( CGAS ) characterized functional impairment at baseline and following treatment . The Child Health Question naire ( CHQ ) assessed HRQOL at baseline . RESULTS Baseline CHQ showed greater impairment in psychosocial functioning than in physical health . Baseline mean CGAS scores were substantially below normal ( i.e. , < 70 ) , indicating functional impairment . Improvement in CGAS scores occurred as early as the first week of treatment . The low correlations between both CHQ and CGAS and the efficacy measures at baseline indicate that these scales measure different constructs . Nevertheless , there was good correlation between improvements in the CGAS and changes in Brief Psychiatric Rating Scale-Anchored ( BPRS-A ) and Young Mania Rating Scale ( YMRS ) during ziprasidone treatment . CONCLUSION CHQ and CGAS scales may be useful together with st and ard efficacy measures for children and adolescents with these disorders Measurement of health-related quality of life ( HRQOL ) in attention-deficit-hyperactivity disorder ( ADHD ) gives a more complete picture of day-to-day functioning and treatment effects than behavioural rating alone . The aim of this pilot study was to investigate the impact of the combined diagnoses of developmental coordination disorder ( DCD ) and ADHD on HRQOL , and the effectiveness of methylpheni date ( MPH ) on HRQOL . HRQOL was established using the Dutch-Child-AZL-TNO- Quality -of-Life ( DUX-25 ) and the TNO-AZL-Child- Quality -of-Life ( TACQOL ) question naires , completed by children and parents . HRQOL of these children was compared with that of 23 age- and sex-matched healthy controls . Twenty-three children ( 21 males , two females ; mean age 8 y 6 mo , [ SD 3 mo ] range 7 y-10 y 8 mo ) with ADHD/DCD entered a 4-week , open-label MPH study , after MPH-sensitivity was established , in a double-blind , placebo-controlled trial . In these children 's self- and proxy reports , impact of both DCD and ADHD was reflected in lower general well-being ( self and proxy report p=0.001 ) due to lower functioning in motor ( selfp=0.026 ; proxy 0.001 ) , autonomic ( self p<0.001 ; proxy p=0.047 ) , cognitive ( self p=0.001 ; proxy p=0.01 ) , and social ( self and proxy p<0.001 ) domains . HRQOL scores improved in 18 children receiving MPH ( p=0.001 ) versus controls . The ADHD /DCD group also demonstrated a significant improvement in ADHD symptoms ( p<0.001 ) and motor functioning ( p<0.001 ) . Additional motor therapy will still be needed in about half of the children with ADHD/DCD receiving MPH , within multimodal treatment including educational and psychosocial assistance BACKGROUND Anecdotal reports and some studies suggest that equine-assisted activities may be beneficial in autism spectrum disorders ( ASD ) . OBJECTIVE To examine the effects ofequine-assisted activities on overall severity of autism symptoms using the Childhood Autism Rating Scale ( CARS ) and the quality ofparent-child interactions using the Timberlawn Parent-Child Interaction Scale . In addition , this study examined changes in sensory processing , quality of life , and parental treatment satisfaction . DESIGN AND PARTICIPANTS Children with ASD were evaluated at four time points : ( 1 ) before beginning a 3-to-6 month waiting period , ( 2 ) before starting the riding treatment , and ( 3 ) after 3 months and ( 4 ) 6 months of riding .  Twenty-four participants completed the waiting list period and began the riding program  , and 20 participants completed the entire 6 months of riding . Pretreatment was compared to posttreatment with each child acting as his or her own control . RESULTS A reduction in the severity of autism symptoms occurred with the therapeutic riding treatment . There was no change in CARS scores during the pretreatment baseline period ; however , there was a significant decrease after treatment at 3 months and 6 months of riding . The Timberlawn Parent-Child Interaction Scale showed a significant improvement in Mood and Tone at 3 months and 6 months of riding and a marginal improvement in the reduction of Negative Regard at 6 months of riding . The parent-rated quality of life measure showed improvement , including the pretreatment waiting period . All of the ratings in the Treatment Satisfaction Survey were between good and very good . CONCLUSION These results suggest that children with ASD benefit from equine-assisted activities OBJECTIVE To examine ( 1 ) moderating effects of oppositional defiant disorder ( ODD ) on attention-deficit/hyperactivity disorder ( ADHD ) treatment response and ( 2 ) responses of ODD symptoms to atomoxetine . METHOD Children and adolescents ( ages 8 - 18 ) with ADHD were treated for approximately 8 weeks with placebo or atomoxetine ( fixed dosing : 0.5 , 1.2 , or 1.8 mg/kg/day , b.i.d . ) under r and omized , double-blind conditions . Among patients with lifetime diagnostic information ( n = 293 ) , 39 % were diagnosed with comorbid ODD and 61 % were not . Treatment-group differences and differences between patients with and without comorbid ODD were examined post hoc for changes on the Attention-Deficit/Hyperactivity Disorder Rating Scale IV-Parent version , investigator-administered and -scored ; Conners ' Parent Rating Scale-Revised Short Form ; Clinical Global Impressions Severity of ADHD Scale ; and the parent-rated Child Health Question naire . RESULTS Youths with ADHD and comorbid ODD showed statistically significant improvement in ADHD , ODD , and quality -of-life measures . Treatment response was similar in youths with and without ODD , except that the comorbid group showed improvement compared with placebo at 1.8 mg/kg/day but not 1.2 mg/kg/day . In contrast , youths without ODD showed improvement at 1.2 mg/kg/day and no incremental benefit at 1.8 mg/kg/day . CONCLUSIONS Atomoxetine treatment improves ADHD and ODD symptoms in youths with ADHD and ODD , although the comorbid group may require higher doses OBJECTIVE To evaluate the feasibility and helpfulness of a behavioral sleep program for children with ADHD , and explore the impact of different program dosages on child and family outcomes . METHODS R and omised trial comparing a brief ( 1 session , n=13 )  and extended ( 2 - 3 sessions , n=14 )  sleep program in children with ADHD ( aged 5 - 14 years ) and at least one behavioral sleep disorder ( American Academy of Sleep Medicine Criteria ) . Outcomes included helpfulness and use of interventions , child sleep ( parent-reported sleep problem ; Child Sleep Habits Question naire ) , ADHD symptoms ( ADHD IV Rating Scale ) , daily functioning ( Daily Parent Rating of Evening and Morning Behavior ) , quality of life ( Pediatric Quality of Life Inventory ) , and caregiver mental health ( Depression Anxiety Stress Scales ) . RESULTS Twenty-seven families ( 63 % of those eligible ) took part . Most parents would recommend the program to others ( 95 % ) and found the strategies helpful . Five months post-r and omisation , 67 % of parents in both groups reported that their child 's sleep problems had resolved . Child quality of life , daily functioning , and parental anxiety also improved in the extended group only ( Cohen 's d : 0.39 , 0.47 and 0.50 , respectively ) . There was minimal change in ADHD symptom scores from baseline to 5 months in either group . CONCLUSIONS A behavioral sleep intervention in children with ADHD is feasible to deliver and improves child sleep by parent report . The extended program result ed in greater improvements in child and caregiver outcomes OBJECTIVE The aim of this study was to examine whether quetiapine is superior to placebo in the treatment of adolescents with conduct disorder . METHODS This was a 7-week , r and omized , double-blind , placebo-controlled pilot study with two parallel arms . Nine youths were r and omly assigned to receive quetiapine , and 10 youths were r and omly assigned to receive placebo .  Patients were assessed weekly throughout the trial . Quetiapine was dosed twice daily , and medications could be titrated flexibly through the end of study week 5 . The dose was fixed for the final 2 weeks of the study . The primary outcome measures were the clinician-assessed Clinical Global Impressions-Severity ( CGI-S ) and -Improvement ( CGI-I ) scales . Secondary outcome measures included parent-assessed quality of life , the overt aggression scale ( OAS ) , and the conduct problems subscale of the Conners ' Parent Rating Scale ( CPRS-CP ) . RESULTS The final mean dose of quetiapine was 294 + /- 78 mg/day ( range 200 - 600 mg/day ) . Quetiapine was superior to placebo on all clinician-assessed measures and on the parent-assessed quality of life rating scale . No differences were found on the parent-completed OAS and CPRS-CP .  Quetiapine was well tolerated . One patient r and omized to quetiapine developed akathisia , requiring medication discontinuation . No other extrapyramidal side effects occurred in patients receiving active drug . CONCLUSIONS This method ologically controlled pilot study provides data that quetiapine may have efficacy in the treatment of adolescents with conduct disorder . Because of the preliminary nature of the study , further research with larger sample s is needed to confirm these findings Objective : To explore the clinical outcomes of children/adolescents with attention-deficit/hyperactivity disorder ( ADHD ) who required a therapy switch from atomoxetine to OROS ® methylpheni date ( MPH ) .  Methods : This prospect i ve , noninterventional study involved patients aged 6–18 years with a confirmed diagnosis of ADHD who experienced insufficient clinical response and /or poor tolerability during atomoxetine treatment . Patients were transitioned to OROS MPH and followed for 12 weeks . ADHD symptoms , functional outcomes , health-related quality of life ( HRQoL ) and tolerability were assessed throughout the study . Results : 42 patients ( intention-to-treat ) transitioned from atomoxetine 43.2 plus 14.7 mg onto OROS MPH 33.0 plus 17.7 mg ( mean daily starting dose ) , increasing to 38.6 plus 17.6 mg at the final visit . Median treatment duration was 85 days ( range : 3–155 ) . Compared with baseline , symptoms , functional outcome and HRQoL improved after transitioning to OROS MPH as assessed by the Conners ’ Parent Rating Scale ( mean change from baseline : -10.1 ± 11.6 ; p < 0.0001 ) , Children ’s Global Assessment Scale ( 8.7 ± 16.2 ; p = 0.0015 ) and ILC-LQ0–28 scores ( parents ’ rating from 14.9 ± 3.6 [ baseline ] to 17.5 ± 4.8 [ study end ] ; p = 0.0002 ; patients ’ rating from 16.9 ± 3.9 [ baseline ] to 19.3 ± 4.4 [ study end ] ; p = 0.0003 ) . Social interactions and late afternoon tasks ( playing with other children , household chores , school homework and behavior towards visitors/at visits ) improved ( p < 0.001 ) . Approximately 62 % expressed satisfaction ( ‘ very good ’ or ` good ’ ) with OROS MPH therapy compared with prior atomoxetine with respect to symptom control in the late afternoon . The most common treatment-emergent adverse events after switching were involuntary muscle contractions ( tics ; 16.7 % ) , insomnia ( 14.3 % ) , abdominal pain ( 9.5 % ) and headache ( 9.5 % ) . No clinical ly relevant changes in body weight or vital signs were observed . Conclusion : In this naturalistic setting , transitioning from atomoxetine to OROS MPH was associated with improved ADHD symptoms and impacted positively on patients ’ and parents ’ HRQoL and disease burden in ADHD children who demonstrated an insufficient response and /or poor tolerability to atomoxetine
target: The systematic review revealed widespread utilization of developmentally appropriate QL instruments but less frequent use of both self and proxy reports and an inconsistent approach to age group specificities .
background: Research on the quality of life ( QL ) of children/adolescents with psychological disorders has flourished over the last few decades .
  Given the developmental challenges of QL measurements in pediatric population s , the aim of this study was to ascertain the extent to which a developmental approach to  QL assessment has been applied to pedopsychiatric QL research .