Analysis of individual items on the attention-deficit/hyperactivity disorder symptom rating scale in children and adults: the effects of age and sex in pivotal trials of lisdexamfetamine dimesylate

Richard H Weisler,1,2 Lenard A Adler,3 Scott H Kollins,4 David W Goodman,5 Mohamed Hamdani,5 Bryan Dirks,6 Ann C Childress71Duke University Medical Center, Durham, NC, USA; 2University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 3New York University School of Medicine and Psychiatry Service, New York VA Harbor Healthcare System, New York, NY, USA; 4Duke University Medical Center, Durham, NC, USA; 5Johns Hopkins University School of Medicine, Baltimore, MD, USA; 6Shire Development LLC, Wayne, PA, USA; 7Center for Psychiatry and Behavioral Medicine, Las Vegas, NV, USABackground: Attention-deficit/hyperactivity disorder (ADHD) symptom presentation across age and sex has not been fully elucidated. The present post hoc analyses qualitatively explored the baseline levels of ADHD symptomatology across subgroups in two clinical trials of children and adults with ADHD to elucidate differences in participant presentation. The response to treatment was examined to determine patterns of response among items of the ADHD Rating Scale IV.Methods: Exploratory post hoc analyses of ADHD Rating Scale IV item scores were conducted on data from two 4-week placebo-controlled trials in children (6–12 years) and in adults (18–55 years) with ADHD. Baseline and endpoint mean item scores were determined for subgroups defined by age (6–9, 10–12, 18–39, and 40–55 years) and sex.Results: The baseline mean item scores were generally numerically similar for all age-by-sex subgroups. The inattention (IA) items were numerically higher than hyperactivity/impulsivity (H/I) items among older children and adults. The endpoint mean item scores were numerically lower after lisdexamfetamine dimesylate treatment for IA and H/I items in all subgroups.Conclusion: These results suggest that regardless of age or sex, baseline IA and H/I symptom profiles were comparable; however, IA vs H/I symptoms were more severe in older participants. In all age-by-sex subgroups, IA and H/I symptoms appeared to decrease after active treatment.Keyword: ADHD symptom item