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More parents than physicians observed oppositional symptoms in children with ADHD
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Parents were more likely than physicians to perceive oppositional symptoms in children with attention-deficit/hyperactivity disorder and more likely to consider these symptoms problematic, according to a poster presentation at the 2010 American Psychiatric Association Annual Meeting in New Orleans.
Overall, 337 physicians participated in the national study conducted by researchers from several U.S. sites.
In the study, 724 chart reviews from patients aged 6 to 17 years who were perceived to have ADHD with or without oppositional symptoms were included, along with 713 parent surveys. Both the physicians and the parents rated the presence of oppositional symptoms using the oppositional subscale of the Conners’ Rating Scale – Revised: Long form (CPRS-R:L). Children whom parents reported as experiencing oppositional symptoms had a mean CPRS-R:L score of 20.4, whereas children without parent-reported oppositional symptoms had a mean CPRS-R:L score of 6.0.
Overall, parents identified 281 children with oppositional symptoms but physicians only agreed in 66% of cases. Almost two-thirds of parents reported more behavioral problems in children with ADHD when oppositional symptoms were present. Regardless of whether parents and physicians did or did not agree that oppositional symptoms were present, physicians perceived oppositional behavior as less problematic, according to the researchers.
Overall, 93% of parents reported at least one of 10 pre-specified oppositional symptoms in their child at diagnosis. However, parents did not talk about these symptoms with their child’s physician, the researchers noted.
“[The fact that] parents and physicians differ in recognizing oppositional symptoms, as highlighted in this study, may have an impact on the effective management of ADHD in these patients. Further studies are warranted to determine the full impact of these findings on patients, their families and the health care system,” the researchers concluded.
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