Influence of executive functions on the self-reported health-related quality of life of children with ADHD

Qual Life Res. 2020 May;29(5):1183-1192. doi: 10.1007/s11136-019-02394-4. Epub 2020 Jan 3.

Abstract

Purpose: ADHD is regarded as a neurodevelopmental disorder associated with deficits in executive functions (EF). The presence of these deficits is associated with increased symptom severity. However, so far there is little knowledge, whether deficits in EFs relate to a reduced health-related quality of life (HRQoL) in children with ADHD.

Methods: Hence, n = 100 children with a confirmed ADHD diagnosis were compared with a non-cases group (n = 100) with regard to their HRQoL (6-12 years old). The clinical group was divided into ADHD-specific drug treatment intake (drug treatment: n = 42; no drug treatment: n = 58) or deficits in EF (n = 29; no deficits in EF: n = 71).

Results: Children with ADHD (without medication) reported a significantly worse HRQoL than healthy children (d = .72), when controlled for age and sex. Even if they were treated with drug treatment, they reported a lower HRQoL than the non-case group in the area Family (d = .53). Drug treatment of ADHD leads to a significant difference in HRQoL in school area (d = .39). Children with ADHD and EF problems reported impairments in the social context of HRQoL compared to healthy children (d = .51 to .70). In addition, a significant negative association between set-shifting and HRQoL in children with ADHD (without drug treatment) was demonstrated (r = - .27 to r = - .35).

Conclusions: By assessing the HRQoL, an impairment in the functioning of children with ADHD can be detected, which is essential for the diagnosis. Furthermore, executive problems have an influence on the social sphere, which should be clarified and improved in therapy with the involvement of parents.

Keywords: ADHD; Children; Executive functions; Health-related quality of life; Set-shifting.

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Child
  • Executive Function / physiology*
  • Female
  • Humans
  • Male
  • Neuropsychological Tests / standards*
  • Quality of Life / psychology*
  • Self Report