How does a real-world child psychiatric clinic diagnose and treat attention deficit hyperactivity disorder?

Table 1 Comparison of vanderbilt attention deficit hyperactivity disorders Diagnostic Rating Scales parent vs teacher results n (%)

		Parent vanderbiltrating scale		Total
		Negative	Positive
Teacher Vanderbilt	Negative	5 (8)	17 (27)	22 (35)
Rating scale	Positive	13 (21)	28 (44)	41 (65)
Total		18 (29)	45 (71)	63 (100)

Table 2 Total attention deficit hyperactivity disorder scores, parent and teacher Vanderbilt attention deficit hyperactivity disorder diagnostic rating scale by positive vs negative diagnostic results (n = 63)

Vanderbilt rating scale	ADHD	n	ParentVADRS total ADHD score	TeacherVADRS total ADHD score	No. of parent’s impairment domains	No. of teacher’s impairment domains
Parent	Negative	5	16.6	10.2	3.4	1.8
Teacher	Negative				(SD ± 0.9)	(SD ± 1.5)
Parent	Negative	13	26.4	32.6	1.1	4.4
Teacher	Positive				(SD ± 0.5)	(SD ± 1.9)
Parent	Positive	17	33.7	16.6	2.9	1.7
Teacher	Negative				(SD ± 0.4)	(SD ± 1.6)
Parent	Positive	28	37.3	34.0	3.7	5.7
Teacher	Positive				(SD ± 1.8)	(SD ± 1.6)
Statistics			11.3	21.4	7.5	24.7
F ratio, df = 3			(P < 0.00011)	(P < 0.00011)	(P < 0.00031)	(P < 0.00011)
Total mean score (%)			32.4	27.1	2.9	4.0

¹Statistically significant at a significance level of 0.05. ADHD: Attention deficit hyperactivity disorder; VADRS: Vanderbilt ADHD diagnostic rating scale.

Table 3 Comparison of psychiatrists’ diagnoses of oppositional defiant disorder with parent or teacher Vanderbilt attention deficit hyperactivity disorder Diagnostic Rating Scale n (%)

		Psychiatrist ODDdiagnosis		Total
		Negative	Positive
Vanderbilt	Negative	27 (46)	3 (5)	30 (51)
ODD
screening	Positive	17 (29)	12 (20)	29 (49)
Total		44 (75)	15 (25)	59

ODD: Oppositional defiant disorder.

Table 4 Total parent and teacher oppositional defiant disorder scale scores, grouped by positive/negative oppositional defiant disorder diagnostic criteria, child and adolescent psychiatrist vs vanderbilt attention deficit hyperactivity disorder diagnostic rating scale

Diagnostic source	ODD	n	Parent VADRS total ODD score	Teacher VADRS total ODD score	No. of parent’s impairment domains	No. of teacher’s impairment domains
CAP	Negative	27	6.1	1.1	2.3	3.7
VADRS	Negative
CAP	Negative	17	14.2	4.0	3.7	3.9
VADRS	Positive
CAP	Positive	3	4.0	2.0	3.3	2.3
VADRS	Negative
CAP	Positive	12	15.2	10.3	3.2	5.4
VADRS	Positive
Statistics F Ratio, df = 3			24.9 (P < 0.00011)	12.0 (P < 0.00011)	2.4 (P = 0.07)	1.9 (P = 0.14)
Total mean score (%)			10.2 (10.2/24 = 43%)	3.8 (3.8/30 = 13%)	2.9	4.0

¹Statistically significant at a significance level of 0.05. ODD: Oppositional defiant disorder; CAP: Child and adolescent psychiatrist; VADRS: Vanderbilt ADHD diagnostic rating scales.

Table 5 Psychiatric treatment recommendations for attention deficit hyperactivity disorder patients with vs without oppositional defiant disorder comorbidity (n = 59)

Diagnostic source	ODD	n	Medication therapy only	Behavior therapy only	Combined treatment
CAP	Negative	27	15 (25%)	1 (2%)	11 (19%)
VADRS	Negative
CAP	Negative	17	3 (5%)	0 (0%)	14 (24%)
VADRS	Positive
CAP	Positive	3	0 (0%)	1 (2%)	2 (3%)
VADRS	Negative
CAP	Positive	12	0 (0%)	3 (5%)	9 (15%)
VADRS	Positive
Total (%)			18 (30%)	5 (9%)	36 (61%)

ODD: Oppositional defiant disorder; CAP: Child and adolescent psychiatrist; VADRS: Vanderbilt ADHD Diagnostic Rating Scales.