Attitudes towards treatment in adolescents with psychiatric disordersqatt questionnaire for the evauation of attitudes towards treatment in adolescents with attention deficit hyperactivity disorder (adhd)

Résumé

Background: A substantial proportion of young people with ADHD do not appropriately adhere to prescribed treatments. Very little is known about factors related to treatment adherence and how attitudes of ADHD subjects may contribute to this. Methods: A 34-item questionnaire comprising questions regarding the opinions, knowledge and attitudes towards medications and other treatments was applied to 120 adolescents diagnosed with ADHD (young people's version)and their respective parents/caregivers (parents' version). Sociodemographic data, family composition, comorbidity, number of previous treatments and type of current treatment were recorded. Reliability of the scale was explored using factor analysis, Chronbach's alpha test, and test-retest. Validity was explored by Face Validity and the Well-Known Groups method. Results: Respondents were between 12 and 18 years old (mean 14.72 years), and mostly boys (82.8%), the majority presenting combined type ADHD. For the young people's version, three main dimensions emerged in factor analysis, namely "preoccupations with medications" (5 items), "insight "(3 items) and "self concept and patient-doctor relationship" (3 items), and explained 37% of variance. For the parents' version, six main dimensions emerged in factor analysis, namely "child's personal attitudes and predisposition for treatment" (4 items), "worries about treatments and alternative treatments for ADHD" (8 items), social stigma(2 items), "insight" (4 items), "worries regarding future side effects and patient-doctor relation" (2 items) and "knowledge" (2 factors) and explained 44% of the total variance. Initial psychometric properties of the scale were appropriate for both versions, with Cronbach's alpha values above 0.6. Test-retest was also adqueate for the total score and each of the three factors in both versions. Known -groups method validity showed that the questionnaire total score discriminated between those patients adhering to clinical attendance and drug treatment intake and those who did not. It also discerned patients who perceived benefits and low perceived side effects of the medication. Conclusions: It is important to disentangle the specific attitudes that contribute to treatment adherence, and how adolescents with ADHD perceive their condition and the various treatment strategies offered to them. The questionnaire has shown adequate psychometric qualities (validity and especially reliability) and thus it may have important implications for the clinical setting. For external validity further replication with bigger sample size and in different clinical settings is required . Keywords: ADHD; attitudes; treatment adherence; medication; adolescents, parents/caregivers