Seventy-eight percent of psychiatrists and parents provide different
responses when asked about patients' 'most concerning behavior'
ORLANDO, Fla., Oct. 25 /PRNewswire/ -- According to a small-scale, in-office, observational study, psychiatrists and parents have significantly different perceptions of the importance of pediatric ADHD and psychiatric comorbidities, particularly regarding the patients' most concerning behavior. The study, which utilized accepted sociolinguistic methodologies to evaluate the tone, content and structure of in-office visits, was presented recently at the 20th annual U.S. Psychiatric and Mental Health Congress (USPMHC).
"We found that among the psychiatrists and parents studied, 78 percent provided different responses when asked about the patient's 'most concerning behavior,'" said Robert Findling, M.D., lead author and professor of psychiatry at Case Western Reserve University and director of the division of child and adolescent psychiatry at University Hospitals Case Medical Center. "There was a notable incidence of psychiatrist/parent misalignment regarding the patients' most concerning behaviors, including aggression and defiance."
The study, designed to capture naturally occurring conversations between psychiatrists, patients with ADHD and their parents, consisted of eleven psychiatrists, thirty-two child and adolescent ADHD patients and their parents. Half of the patients were younger than 13 years old, and the majority fulfilled the criteria of "complicated ADHD," which was defined in the study as a patient "having or suspected to have one or more psychiatric comorbidities." Physicians classified 81 percent of patients as having one or more psychiatric comorbidities/learning disabilities. The most common comorbidities greater than 20 percent included: depression (46 percent), oppositional defiant disorder (42 percent), anxiety (38 percent), learning disabilities (35 percent) and bipolar disorder (23 percent). In post-visit interviews, parents most often reported concern about aggression and defiance; however, these behaviors that parents reported as "most concerning" post-visit were unaddressed in one-third of the visits.
"These results indicate psychiatrists can adopt several techniques to improve in-office communication about complicated ADHD, including structuring visits, so that all voices are heard, discussing comorbidities using language that is more comprehensible to parents, and eliciting parents' expectations at the initiation of treatment," said Dr. Findling. "By focusing on how time is spent and what types of questions are asked of parents and patients, this can lead to successful expectation-setting with both parents and patients. As a result, psychiatrists can have better in-office discussions about ADHD as well as improved treatment of patients suffering from complicated ADHD."
Approximately 7.8 percent of all school-age children, or about 4.4 million U.S. children aged 4 to 17 years, have been diagnosed with ADHD at some point in their lives, according to the U.S. Centers for Disease Control and Prevention (CDC). ADHD is one of the most common psychiatric disorders in children and adolescents. The disorder is also estimated to affect 8.1 percent of adults, or approximately 9.2 million adults across the U.S. based on a retrospective survey of adults aged 18 to 44, projected to the full U.S. adult population. ADHD is a neurobiological disorder that manifests as a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development. To be properly diagnosed with ADHD, a child needs to demonstrate at least six of nine symptoms of inattention; and/or at least six of nine symptoms of hyperactivity/impulsivity; the onset of which appears before age 7 years; that some impairment from the symptoms is present in two or more settings (e.g., at school and home); that the symptoms continue for at least six months; and that there is clinically significant impairment in social, academic or occupational functioning and the symptoms cannot be better explained by another psychiatric disorder.
Although there is no "cure" for ADHD, there are accepted treatments that specifically target its symptoms. The most common standard treatments include educational approaches, psychological or behavioral modification, and medication.
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Porter Novelli for Shire
A Sociolinguistic Analysis of In-Office Dialogue about ADHD and Psychiatric Comorbidities among Psychiatrists, Child and Adolescent Patients and Their Parents
October 11, 2007; 3:45 p.m. EDT
Shire Development Inc. provided funding for this study.
Shire's strategic goal is to become the leading specialty biopharmaceutical company that focuses on meeting the needs of the specialist physician. Shire focuses its business on attention deficit and hyperactivity disorder (ADHD), human genetic therapies (HGT), gastrointestinal (GI) and renal diseases. The structure is sufficiently flexible to allow Shire to target new therapeutic areas to the extent opportunities arise through acquisitions. Shire's in-licensing, merger and acquisition efforts are focused on products in niche markets with strong intellectual property protection either in the US or Europe. Shire believes that a carefully selected portfolio of products with strategically aligned and relatively small-scale sales forces will deliver strong results.
For further information on Shire, please visit the Company's website: http://www.shire.com
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Statements included herein that are not historical facts are forward- looking statements. Such forward-looking statements involve a number of risks and uncertainties and are subject to change at any time. In the event such risks or uncertainties materialize, Shire's results could be materially affected. The risks and uncertainties include, but are not limited to, risks associated with: the inherent uncertainty of pharmaceutical research, product development, manufacturing and commercialization; the impact of competitive products, including, but not limited to the impact of those on Shire's Attention Deficit and Hyperactivity Disorder ("ADHD") franchise; patents, including but not limited to, legal challenges relating to Shire's ADHD franchise; government regulation and approval, including but not limited to the expected product approval date of INTUNIV(TM) (guanfacine) extended release (ADHD); Shire's ability to secure new products for commercialization and/or development; Shire's ability to benefit from its acquisition of New River Pharmaceuticals, Inc.; the successful development of JUVISTA(R) (human TGFBeta3) and other risks and uncertainties detailed from time to time in Shire plc's filings with the Securities and Exchange Commission, particularly Shire plc's Annual Report on Form 10-K for the year ended December 31, 2006.
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