E-ISSN: 1309-5749 | ISSN: 1018-8681 | Join E-mail List | Contact | Twitter
Effects of methylphenidate treatment on quality of life in adolescents
1Dr. Ekrem Tok Psychiatry and Mental Health Hospital, Department of Child and Adolescent Psychiatry, Adana - Turkey
2Mersin University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mersin - Turkey
3Cukurova University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Adana - Turkey
Dusunen Adam Journal of Psychiatry and Neurological Sciences 2018; 31(1): 11-20 DOI: 10.5350/DAJPN2018310101
Full Text PDF Full Text PDF (Turkish)


Objective: Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood mental disorders. Improvement in quality of life is observed with the treatment of ADHD which is a chronic disorder that disrupts the quality of life. In this study, it was aimed to investigate the changes in symptoms of anxiety and depression associated with ADHD and quality of life of adolescents after methylphenidate treatment.

Method: Fifty patients between 13-18 years old, who admitted to Mersin University Medical Faculty Hospital Pediatric and Adolescent Psychiatry Outpatient Clinics; were diagnosed with ADHD; received methylphenidate treatment for the first time; and continued with the treatment for three months; were included in the study. Pretreatment and 3rd month results of Children’s Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAI-CH), and adolescent and parent forms of Pediatric Quality of Life InventoryTM 4.0 (PedsQLTM 4.0) were assessed by retrospectively screening of patient charts.

Results: After methylphenidate treatment, quality of life scores were improved, except for physical functioning. Quality of life scores were higher in adolescent reports, compared to parents. Male adolescents scored their quality of life more positively than girls before and after the treatment. In addition, anxiety symptoms improved after methylphenidate treatment.

Conclusion: It is important to determine the changes in quality of life with the treatment of ADHD in terms of emphasizing the importance of ADHD treatment, evaluating treatment outcomes, and establishing effective and sophisticated treatment plans.


Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder characterized by more frequent, persistent, or severe attention deficit and/or hyperactivity-impulsivity symptoms, compared with individuals of similar developmental status (1).

ADHD is one of the most common and most frequently investigated disorders in the field of child mental health. It has been reported that the frequency in school-age children varies from 3% to 8% and it is more common among males (2). ADHD leads to cognitive, academic, social, and emotional impairment (3).

As the perspective of “improving health” rather than “maintaining life” emerged as a treatment conception, assessment of quality of life has become increasingly important in improving both physical and mental health (4). From this point of view, there are a number of studies investigating the effects of ADHD symptoms, on quality of life (5-7). It has been reported that quality of life is impaired due to ADHD and it is improved with the treatment of ADHD symptoms (8). Assessment of ADHD treatment by quality of life is useful in assessing the psychosocial consequences of this disorder that are difficult to capture by evaluating only clinical manifestations (9). At the same time, symptom severity and the presence of co-morbid mental disorders also affect the quality of life (10).

There are a number of studies investigating the changes in the quality of life with medical treatment of ADHD symptoms. Most of these studies have been conducted with atomoxetine, whereas studies with methylphenidate (MPH) are fewer.

This study was planned in the light of the literature showing that quality of life improved in parallel with the treatment of ADHD symptoms. The aim of the study–that gives its originality–is to assess the effect of ADHD treatment with MPH on the quality of life of in adolescent sample.


The sample of the study consisted of 50 patients between 13-18 years of age who applied to the Child and Adolescent Psychiatry Outpatient Clinic of Mersin University Medical Faculty between June and October 2012, who were diagnosed with ADHD according to DSM-IV-TR criteria and have received MPH treatment for the first time. The subjects who have maintained the treatment regularly for at least 3 months were included in the study. Psychosis, pervasive developmental disorder, and mental retardation patients were excluded from the study. ADHD and co-morbidity diagnoses were made according to DSM-IV diagnostic criteria via clinical interviews conducted by a child and adolescent psychiatrist. Mersin University Ethics Committee approved the study (10.05.2012/2012-192). Sociodemographic and clinical data were obtained by retrospective screening of patient files. Scores of the scales that were filled in by the subjects and their parents at the beginning of the treatment and at the end of the third month were included in the analysis.


State-Trait Anxiety Inventory for Children (STAI-CH): The State-Trait Anxiety Inventory developed by Spielberger consists of two 20 item subscales that measure consistent and state anxiety. Turkish validity and reliability study of the scale was made by Ozusta (11). The scale is answered by the child or the adolescent. The items of both subscales are scored from 1 to 3. Only the Trait Anxiety Inventory (TAI) was used in our study. Scores of TAI ranges from 20 to 60 points. Higher scores indicate higher anxiety levels (12).

Children’s Depression Inventory (CDI): It was prepared by Kovacs (13) based on the Beck Depression Scale. Turkish validity and reliability study of the scale was made by Oy (14). The scale is answered by the child or the adolescent. The scale consists of 27 items. The subject is asked to choose best fit from 3 options in each item. Each item is scored as 0, 1, or 2. Total score ranges between 0-54 points. Cut-off point is 19 or above (13).

Pediatric Quality of Life InventoryTM 4.0 (PedsQL™ 4.0): It is a general quality of life scale, developed by Varni (15), that assesses the physical and psychosocial experiences of children and adolescents aged 2-18 years. The Turkish validity and reliability study of the 13-18 year old adolescent form, which is used in our study, was done by Memik et al. (16). The scale consists of a total of 23 items in 4 sub-parts: physical functioning, social functioning, emotional functioning, and school functioning. Each item is scored as 100 if “never” is marked; 75 if “almost never” is marked; 50 if “sometimes” is marked; 25 if “often” is marked; and 0 if “almost always” is marked. Finally the Physical Health Summary Score and the Psychosocial Health Summary Score–which is the sum of the social, emotional, and school functioning scores–were obtained. The subscale and total scores are obtained by dividing the scores with the number of filled items. The higher the scale score is the better the quality of life is assumed. We chose PedsQL™ 4.0 to use in our study because it includes adolescent and parental reporting. The possibility of evaluating the level of agreement between adolescent and parent about adolescent’s quality of life increases the importance of the scale (17,18).

Statistical Analysis

SPSS 11.5 software (IBM) package was used to analyze the data. Mean and standard deviation values of the scale scores are presented as descriptive statistics. Number and percentage values were calculated for categorical variables. Shapiro Wilk test was used to evaluate normal distribution of continuous variables and it was seen that all the scale scores were not normally distributed. Scale scores of the two independent groups were compared with non parametric Man-Whitney U test. Non parametric Wilcoxon test was used to evaluate the differences between pre and post-treatment scale scores. Chi-square Test was used to compare the differences between categorical variables. Correlations between scale scores were calculated by Pearson’s Correlation Test. p values smaller than 0.05 were considered statistically significant.


The ages of participants were 13-18 years with a mean age of 14.54±1.69 years. Sixty-four percent (n=32) of the cases were middle school students, while 36% (n=18) of them were high school students.

Of the 50 patients diagnosed with ADHD according to the DSM-IV diagnostic criteria, 78% were classified as combined type (CT) (n=39; girls n=13, 72.0%; boys n=26, 81.3%) and 22% were classified as Predominantly Inattentive type (PI) (n=11; girls n=5, 27.8%; boys n=6, 18.8%). We have not observed any case of Predominantly hyperactive-impulsive type in our study. In 42% of the cases (n=21) at least one psychiatric disorder accompanied the diagnosis of ADHD, while in 8% (n=4) more than one comorbidity was found. The most common comorbid psychiatric disorder was anxiety disorder (14%, n=7), followed by behavioral disorder (10%, n=5), nocturnal enuresis (6%, n=3), and specific learning difficulty (4%, n=2). There were 9 patients (18%) that have a physical disease in addition to ADHD.

All participants have been prescribed long-acting MPH for the treatment of ADHD, with an average MPH dose of 0.95±0.16mg/kg/day (0.7 to 1.4mg/kg/day). There were 10 patients (20%) who received a second drug treatment in addition to MPH.

When pre-treatment and third month scale scores were compared, there was a statistically significant change in the STAI-CH scores of the total group, in the boys group, and in the combined type group after the treatment, whereas the changes observed in the PedsQL™ 4.0 scores were significant in the PI sub-type (Table 1). The changes in scores of the whole sample before and after treatment are shown in Table 1.

When we evaluated the effect of treatment on quality of life with PedsQL™ 4.0; there was a significant difference in physical functioning score (PFS), school functioning score (SchoolFS) and psychosocial functioning score (PSFS) of the adolescent form; whereas there was a significant difference in social functioning score (SFS), and PSFS of the parental form before and after treatment (Table 2).

When parental and adolescent statements about the effect of ADHD on quality of life were compared, it was found that adolescents rated their own quality of life significantly more positive than parents in all fields except in SchoolFS before treatment and PFS after treatment (Table 2).

When the effect of gender on the quality of life was evaluated; both the pre-treatment and post-treatment PedsQL™ 4.0 subscale and total scores except for SFS and PSS were found to be significantly lower in female adolescents than in males (Table 3). The findings of the adolescent and parental pre- and post-treatment PedsQL™ 4.0 scores according to gender are shown in Table 3.

When the relationship between ADHD subtypes and quality of life was examined; there was no significant difference in terms of subtypes either before or after treatment in the adolescent and parent forms of PedsQL™ 4.0 (Table 4). However, there was a significant increase in some subscale scores of the PedsQL™ 4.0 before and after treatment (Table 4).

When the impact of the presence of mental illness accompanying ADHD on the quality of life was assessed; in cases with co-morbidities, significant elevation was observed only in the SchoolFS, whereas in cases without a co-morbidity, there was a significant increase with treatment in total scores and in all subscales of PedsQL™ 4.0 except emotional functioning score (EFS) and PFS (Table 5).


In our study it has been shown that MPH treatment has positive effects on both quality of life and symptoms of anxiety and depression in adolescents with ADHD. The vast majority of the studies in the literature evaluating the effect of ADHD treatment on quality of life are made with atomoxetine, whereas studies with MPH are rare (19). In addition, it has been observed that the age range is wider in the sample of these studies. Cognitive levels, which may vary between age groups, may have an impact on the perception of quality of life; therefore, an assessment to be made within the same age group is considered to be healthier. Our study, which was planned in the light of this need in the literature, is the first study evaluating the quality of life of adolescents with ADHD who take MPH treatment.

When the quality of life studies in the literature were examined, the cases with ADHD have generally been compared with healthy controls or those with other chronic diseases (5-7,10); and the quality of life scores were found to be lower in ADHD, especially in the psychosocial domain (15,19-21). Studies investigating changes in quality of life with atomoxetine treatment have shown a significant increase in post-treatment psychosocial subscale scores compared to placebo (22,23). In a study comparing atomoxetine and MPH, it was determined that improvement in the quality of life was achieved with treatment in both groups, there was more improvement in the group receiving atomoxetine. According to the authors, this difference is due to the permanent effects of atomoxetine, less fluctuating characteristics, and its effect on additional symptoms such as anxiety or tic (24).

In the quality of life studies performed with MPH, there was a significant increase in the total scores and subscale scores except the PFS after MPH treatment (25,26). It is thought that, the side effects such as decreased appetite and abdominal pain play a role in the decrease in PFS (26-29). Consistent with the literature, our study also found a significant decrease in post-treatment PFS and it is considered to be the result of associated side effects. However, SchoolFS and PSFS were significantly increased by MPH treatment in both adolescent and parental reports. It is thought that controlling the core symptoms of ADHD with MPH leads to this positive effect on quality of life (30,31).

It looks like evaluating parent and child/adolescent forms simultaneously would be more reliable in assessing quality of life. The level of consistency between the child/adolescents and the parental assessment is also important in this evaluation. There are studies in the literature showing that parental and child/adolescent assessments in ADHD are fairly consistent except for SchoolFS (25,32,33) on the other hand there are others showing that the child/adolescent reporting is more positive (34-36). Factors affecting parental reporting include; comparison of the development of their children with other children or their peers, the expectations from the child, the responsibility of caring, family functions, parent’s own mental state and well-being (17,37,38). In addition, children/adolescents with ADHD may have reported their performances more positively than their real capacities (39).

In our study, post-treatment total and all subscale scores were higher in the adolescent report than in the parental report; and the differences except the PFS were statistically significant. These differences are thought to be: because the adolescent tends to score higher on his or her own functioning and have positive bias (39) and because of the higher level of consensus with the parent about physical health (7,40) since physical health is more objectively observable than psychosocial health (7,40).

When the gender effect on the quality of life in ADHD is examined, post-treatment EFS, SchoolFS, PSFS, and scale total scores in adolescent form and EFS, SchoolFS, and PSFS scores in the parental form were significantly higher in male adolescents. Significant decrease in PFS and significant increase in SchoolFS scores were observed in female adolescents after treatment, while significant increase in SchoolFS and PSFS scores was observed in male adolescents. Previous studies have also reported that female ADHD adolescents rated their own quality of life more negatively (41,42), but that gender did not affect parental rating (42). Unlike our study there is a study in the literature showing that gender has no effect on changes in quality of life with MPH treatment (43). The small size of our sample and the fact that, variables such as co-morbidity, additional drug use, and symptom severity have not been assessed, may have led to these differences from the literature.

In studies comparing the quality of life of ADHD subtypes, it was observed that all subtypes had lower scores compared to controls, especially with lower PFS scores in ADD subtype (44). However, there are also publications showing that the effect of ADHD subtypes on quality of life is similar (42). In our study, there were no significant differences in either adolescent or parental quality of life total and subscale scores in terms of ADHD subtypes before and after treatment. Our findings support the idea that ADHD may lead to similar impairment without regard to the subtype (42). However, the fact that our small sample size is small makes it difficult to compare and comment on.

Contrary to the publications (10,23) that reports the presence of comorbidity negatively affects quality of life in ADHD, there was no significant difference in pretreatment quality of life scores between the patients with and without comorbidity in our study. Small sample size of our study and the imbalanced comorbidity distribution with the literature can be considered as the cause of the dissimilarity. After the treatment there were improvements in more fields of life quality in the group without comorbidities. It is possible that the presence of comorbidity can also deteriorate the response to treatment therefore, improvement is observed in fewer fields of life quality (9,34).

In opposition to publications (45,46) in the literature that suggest that the use of MPH in patients with ADHD may aggravate anxiety (45,46), there are also studies showing that anxiety decreases with MPH (47-49). In the study of Gurkan et al. (26) 8-14 years old children and adolescents with ADHD were treated with an average of 24.2mg/day MPH dose for 3 months. Anxiety and depression scores of the subjects have been reported to decrease significantly. Similarly, there was a significant decrease between pre-treatment STAI-CH scores and 3 months after treatment in our study. The reduction in anxiety scores can be supposed to be secondary to the improvement of the core symptoms of ADHD and to improvements in social, academic, and behavioral areas rather than direct effect of MPH on anxiety symptoms. Another possibility is that depression and anxiety scores may also decrease as the mood dysregulation, which is considered as a part of ADHD, improves with MPH, as shown in adult ADHD studies (50,51). Another possible factor is, in our study 20% of adolescents were using another drug (antidepressant, antipsychotic) additional to MPH. However, it may be misleading to make an explicit comment on the effect of this condition on scale scores since additional drug use was not taken into consideration when comparing the change in anxiety and depression scores with treatment.

The sample size is one of the limitations of our study. For this reason, there is a need for larger sample studies on adolescents. Another limitation is that ADHD and co-morbidity diagnoses are via clinical interviews based on DSM-IV criteria rather than using structured scales. The presence of patients receiving additional drug treatment for MPH is also a limitation of our study because it can affect quality of life, anxiety, and depression scores.

ADHD which has a very important place in childhood psychiatric diseases, causes physical, academic, social, and emotional disturbances as well as serious disruptions in daily life and family functioning (52). It affects the quality of life negatively, especially in the psychosocial domain. The evaluation of the clinical manifestations of ADHD and the efficacy of treatment with the quality of life seems to be very important as it will allow for individual interventions in functionality which is a more problematic field.

Conflict of Interest: Authors declared no conflict of interest.

Financial Disclosure: Authors declared no financial support.


1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. Fourth Ed. Washington, DC: American Psychiatric Association, 1994.

2.Floet AM, Scheiner C, Grossman L. Attention-deficit/hyperactivity disorder. Pediatr Rev 2010; 31:56-69. [CrossRef]

3.Graham J, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Dittmann RW, Döpfner M, Hamilton R, Hollis C, Holtmann M, Hulpke-Wette M, Lecendreux M, Rosenthal E, Rothenberger A, Santosh P, Sergeant J, Simonoff E, Sonuga-Barke E, Wong IC, Zuddas A, Steinhausen HC, Taylor E; European Guidelines Group. European guidelines on managing adverse effects of medication for ADHD. Eur Child Adolesc Psychiatry 2011; 20:17-37. [CrossRef]

4.Coghill D, Danckaerts M, Sonuga-Barke E, Sergeant J; ADHD European Guidelines Group. Practitioner review: quality of life in child mental health—conceptual challenges and practical choices. J Child Psychol Psychiatry 2009; 50:544-561. [CrossRef]

5.Danckaerts M, Sonuga-Barke EJ, Banaschewski T, Buitelaar J, Dopfner M, Hollis C, Santosh P, Rothenberger A, Sergeant J, Steinhausen HC, Taylor E, Zuddas A, Coghill D. The quality of life of children with attention deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 2010; 19:83-105. [CrossRef]

6.Sawyer MG, Whaites L, Rey JM, Hazell PL, Graetz BW, Baghurst P. Health-related quality of life of children and adolescents with mental disorders. J Am Acad Child Adolesc Psychiatry 2002; 41:530-537. [CrossRef]

7.Bastiaansen D, Koot HM, Ferdinand RF, Verhulst FC. Quality of life in children with psychiatric disorders: self-, parent, and clinician report. J Am Acad Child Adolesc Psychiatry 2004; 43:221-230. [CrossRef]

8.Matza LS, Rentz AM, Secnik K, Swensen AR, Revicki DA, Michelson D, Spencer T, Newcorn JH, Kratochvil CJ. The link between health-related quality of life and clinical symptoms among children with attention-deficit hyperactivity disorder. J Dev Behav Pediatr 2004; 25:166-174. [CrossRef]

9.Yang P, Hsu HY, Chiou SS, Chao MC. Health-related quality of life in methylphenidate-treated children with attention-deficit-hyperactivity disorder: results from a Taiwanese sample. Aust N Z J Psychiatry 2007; 41:998-1004. [CrossRef]

10.Klassen AF, Miller A, Fine S. Health-related quality of life in children and adolescents who have a diagnosis of attention deficit/hyperactivity disorder. Pediatrics 2004; 114:e541-547. [CrossRef]

11.Ozusta S. Turkish standardization, reliability and validity of State-Trait Anxiety Inventory for Children. Turkish Journal of Psychology 1995; 10:32-44. (Turkish)

12.Oy B, Ilgen R, Ekmekci A, Turkmen M, Yilmaz N, Basoglu N. Application of State-Trait Anxiety Inventory for children to primary and secondary school children. Turk J Child Adolesc Ment Health 1995; 2:76-81. (Turkish)

13.Kovacs M. Rating scale to assess depression in school aged children. Acta Paedopsychiatr 1981; 46:305-315.

14.Oy B. Reliability and validity of Children’s Depression Inventory. Turk J Psych 1991; 2:132-136. (Turkish)

15.Varni JW, Seid M, Rode CA. The PedsQL: measurement model for the pediatric quality of life inventory. Med Care 1999; 37:126-139. [CrossRef]

16.Cakin-Memik N, Agaoglu B, Coskun A, Uneri OS, Karakaya I. The validity and reliability of the Turkish pediatric quality of life inventory for children 13-18 years old. Turk Psikiyatri Derg 2007; 18:353-363. (Turkish)

17.Eiser, C, Morse R. Can parents rate their child’s health-related quality of life? Results of a systematic review. Qual Life Res 2001; 10:347-357. [CrossRef]

18.Upton, P, Lawford, J, Eiser, C. Parent–child agreement across child health-related quality of life instruments: a review of the literature. Qual Life Res 2008; 17:895-913. [CrossRef]

19.Coghill, D. The impact of medications on quality of life in attention-deficit hyperactivity disorder: a systematic review. CNS Drugs 2010; 24:843-866.

20.Wehmeier PM, Schacht A, Barkley RA. Social and emotional impairment in children and adolescents with ADHD and the impact on quality of life. J Adolesc Health 2010; 46:209-217. [CrossRef]

21.Lee YC, Yang HJ, Chen VC, Lee WT, Teng MJ, Lin CH, Gossop M. Meta-analysis of quality of life in children and adolescents with ADHD: By both parent proxy-report and child self-report using PedsQL™. Res Dev Disabil 2016; 51-52:160-172. [CrossRef]

22.Perwien AR, Faries DE, Kratochvil CJ, Sumner CR, Kelsey DK, Allen AJ. Improvement in health-related quality of life in children with ADHD: an analysis of placebo controlled studies of atomoxetine. J Dev Behav Pediatr 2004; 25:264-271. [CrossRef]

23.Newcorn JH, Spencer TJ, Biederman J, Milton DR, Michelson D. Atomoxetine treatment in children and adolescents with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry 2005; 44:240-248. [CrossRef]

24.Prasad S, Harpin V, Poole L, Zeitlin H, Jamdar S, Puvanendran K; SUNBEAM Study Group. A multi-centre, randomised, open-label study of atomoxetine compared with standard current therapy in UK children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Curr Med Res Opin 2007; 23:379-394. [CrossRef]

25.Flapper BC, Schoemaker MM. Effects of methylphenidate on quality of life in children with both developmental coordination disorder and ADHD. Dev Med Child Neurol 2008; 50:294-299. [CrossRef]

26.Gurkan K, Bilgic A, Turkoglu S, Kilic BG, Aysev A, Uslu R. Depression, anxiety and obsessive–compulsive symptoms and quality of life in children with attention-deficit hyperactivity disorder (ADHD) during three-month methylphenidate treatment. J Psychopharmacol 2010; 24:1810-1818. [CrossRef]

27.Banaschewski T, Roessner V, Dittmann RW, Santosh PJ, Rothenberger A. Non-stimulant medications in the treatment of ADHD. Eur Child Adolesc Psychiatry 2004; 13(Suppl.1):I102-116. [CrossRef]

28.Gau SS, Chen SJ, Chou WJ, Cheng H, Tang CS, Chang HL, Tzang RF, Wu YY, Huang YF, Chou MC, Liang HY, Hsu YC, Lu HH, Huang YS. National survey of adherence, efficacy, and side effects of methylphenidate in children with attention-deficit/hyperactivity disorder in Taiwan. J Clin Psychiatry 2008; 69:131-140. [CrossRef]

29.Greenhill L, Kollins S, Abikoff H, McCracken J, Riddle M, Swanson J, McGough J, Wigal S, Wigal T, Vitiello B, Skrobala A, Posner K, Ghuman J, Cunningham C, Davies M, Chuang S, Cooper T. Efficacy and safety of immediate-release methylphenidate treatment for preschoolers with ADHD. J Am Acad Child Adolesc Psychiatry 2006; 45:1284-1293. [CrossRef]

30.Coghill D, Hodgkins P. Health-related quality of life of children with attention-deficit/hyperactivity disorder versus children with diabetes and healthy controls. Eur Child Adolesc Psychiatry 2016; 25:261-271. [CrossRef]

31.Radziuk AL, Kieling RR, Santos K, Rotert R, Bastos F, Palmini AL. Methylphenidate improves the quality of life of children and adolescents with ADHD and difficult-to-treat epilepsies. Epilepsy Behav 2015; 46:215-220. [CrossRef]

32.Varni JW, Burwinkle TM. The PedsQL as a patient-reported outcome in children and adolescents with attention-deficit/hyperactivity disorder: a population-based study. Health Qual Life Outcomes 2006; 4:26. [CrossRef]

33.Yurumez E, Kilic BG. Relationship between sleep problems and quality of life in children with ADHD. J Atten Disord 2016; 20:34-40. [CrossRef]

34.Limbers CA, Ripperger-Suhler J, Heffer RW, Varni JW. Patient-reported Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales in pediatric patients with attention-deficit/hyperactivity disorder and comorbid psychiatric disorders: feasibility, reliability, and validity. Value Health 2011; 14:521-530. [CrossRef]

35.Limbers CA, Ripperger-Suhler J, Boutton K, Ransom D, Varni JW. A comparative analysis of health-related quality of life and family impact between children with ADHD treated in a general pediatric clinic and a psychiatric clinic utilizing the PedsQL. J Atten Disord 2011; 15:392-402. [CrossRef]

36.Jafari P, Ghanizadeh A, Akhondzadeh S, Mohammadi MR. Health-related quality of life of Iranian children with attention deficit/hyperactivity disorder. Qual Life Res 2011; 20:31-36. [CrossRef]

37.Kolsteren MM, Koopman HM, Schalekamp G, Mearin ML. Health-related quality of life in children with celiac disease. J Pediatr 2001; 138:593-595. [CrossRef]

38.Varni JW, Seid M, Kurtin PS. PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care 2001; 39:800-812. [CrossRef]

39.Owens JS, Goldfine ME, Evangelista NM, Hoza B, Kaiser NM. A critical review of self-perceptions and the positive illusory bias in children with ADHD. Clin Child Fam Psychol Rev 2007; 10:335-351. [CrossRef]

40.Uneri O. Cakin Memik N. Concept of quality of life in children and review of inventories about quality of life. Turk J Child Adolesc Ment Health 2007; 14:48-56. [CrossRef] (Turkish)

41.Velő S, Kereszteny A, Szentivanyi D, Balazs J. Quality of life of patients with attention-deficit/hyperactivity disorder: systematic review of the past 5 years. Neuropsychopharmacol Hung 2013; 15:73-82. (Hungarian)

42.Dallos G, Miklósi M, Keresztény Á, Velő S, Szentiványi D, Gádoros J, Balázs J. Self-and parent-rated quality of life of a treatment naïve sample of children with adhd the impact of age, gender, type of ADHD, and comorbid psychiatric conditions according to both a categorical and a dimensional approach. J Atten Disord 2017; 21:721-730. [CrossRef]

43.Manos M, Frazier TW, Landgraf JM, Weiss M, Hodgkins P. HRQL and medication satisfaction in children with ADHD treated with the methylphenidate transdermal system. Curr Med Res Opin 2009; 25:3001-3010. [CrossRef]

44.Graetz BW, Sawyer MG, Hazell PL, Arney F, Baghurst P. Validity of DSM-IV ADHD subtypes in a nationally representative sample of Australian children and adolescents. J Am Acad Child Adolesc Psychiatry 2001; 40:1410-1417. [CrossRef]

45.Epstein T, Patsopoulos NA, Weiser M. Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Syst Rev 2014; (9):CD005041. [CrossRef]

46.Goez H, Back-Bennet O, Zelnik N. Differential stimulant response on attention in children with comorbid anxiety and oppositional defiant disorder. J Child Neurol 2007; 22:538-542. [CrossRef]

47.Coughlin CG, Cohen SC, Mulqueen JM, Ferracioli-Oda E, Stuckelman ZD, Bloch MH. Meta-analysis: reduced risk of anxiety with psychostimulant treatment in children with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol 2015; 25:611-617. [CrossRef]

48.Segev A, Gvirts HZ, Strouse K, Mayseless N, Gelbard H, Lewis YD, Barnea Y, Feffer K, Shamay-Tsoory SG, Bloch Y. A possible effect of methylphenidate on state anxiety: a single dose, placebo controlled, crossover study in a control group. Psychiatry Res 2016; 241:232-235. [CrossRef]

49.Snircova E, Marcincakova-Husarova V, Hrtanek I, Kulhan T, Ondrejka I, Nosalova G. Anxiety reduction on atomoxetine and methylphenidate medication in children with ADHD. Pediatr Int 2016; 58:476-481. [CrossRef]

50.Reimherr FW, Williams ED, Strong RE, Mestas R, Soni P, Marchant BK. A double-blind, placebo controlled, crossover study of osmotic release oral system methylphenidate in adults with ADHD with assessment of oppositional and emotional dimensions of the disorder. J Clin Psychiatry 2007; 68:93-101. [CrossRef]

51.Rösler M, Fischer R, Ammer R, Ose C, Retz W. A randomized, placebo controlled, 24-week, study of low-dose extendedrelease methylphenidate in adults with attention-deficit/hyperactivity disorder. Eur Arch Psychiatry Clin Neurosci 2009; 259:120-129. [CrossRef]

52.Cussen A, Sciberras E, Ukoumunne OC, Efron D. Relationship between symptoms of attention-deficit/hyperactivity disorder and family functioning: a community-based study. Eur J Pediatr 2012; 171:271-280. [CrossRef]

Ergenlerde metilfenidat tedavisinin yaşam kalitesi üzerine etkisi
1Dr. Ekrem Tok Psikiyatri ve Ruh Sağlığı Hastanesi, Çocuk ve Ergen Psikiyatrisi Kliniği, Adana - Türkiye
2Mersin Üniversitesi Tıp Fakültesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Anabilim Dalı, Mersin - Türkiye
3Çukurova Üniversitesi Tıp Fakültesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Anabilim Dalı, Adana - Türkiye
Dusunen Adam Journal of Psychiatry and Neurological Sciences 2018; 1(31): 11-20 DOI: 10.5350/DAJPN2018310101

Amaç: Dikkat eksikliği hiperaktivite bozukluğu (DEHB) çocukluk çağında en sık görülen ruhsal bozukluklardan birisidir. Yaşam kalitesini bozan süreğen bir bozukluk olan DEHB’nin tedavisi ile yaşam kalitesinde iyileşme gözlenmektedir. Bu çalışmada metilfenidat tedavisi ile ergenin yaşam kalitesindeki ve DEHB’ye sıklıkla eşlik eden kaygı ve depresyon belirtilerindeki değişikliklerin incelenmesi amaçlanmıştır.

Yöntem: Mersin Üniversitesi Tıp Fakültesi Hastanesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Polikliniğine başvuran hastalardan DEHB tanısı almış 13-18 yaş arası, ilk kez metilfenidat başlanmış ve 3 ay tedavisi devam etmiş olan 50 olgu çalışmaya dahil edildi. Olguların arşiv dosyaları taranarak tedavi öncesinde ve 3 ay sonrasında uygulanan Çocuklar İçin Depresyon Ölçeği (ÇİDÖ), Çocuklar İçin Sürekli Kaygı Ölçeği (ÇİSKÖ), Pediyatrik Yaşam Kalitesi EnvanteriTM (PedYKTM 4.0) ergen ve ebeveyn formları değerlendirildi.

Bulgular: Metilfenidat tedavisi sonucunda fiziksel işlevsellik puanı hariç yaşam kalitesi puanlarında yükselme gözlendi. Ergen ve ebeveyn formu karşılaştırıldığında, ergen formunda yaşam kalitesi puanlarının daha yüksek olduğu saptandı. Tedavi öncesinde ve sonrasında erkek ergenlerin kızlara kıyasla yaşam kalitesini daha olumlu puanladıkları gözlendi. Aynı zamanda, metilfenidat tedavisi ile kaygı belirtilerinde de iyileşme olduğu gözlendi.

Sonuç: DEHB’nin tedavisi ile yaşam kalitesindeki değişiklikleri saptamak, DEHB tedavisinin önemini vurgulamak, tedavi sonuçlarını değerlendirmek ve etkin, çok yönlü tedavi planları oluşturmak açısından önemli bir yer tutmaktadır.