Attention deficit hyperactivity disorder: anxiety phenomena in children treated with psychostimulant medication for 6 months or more

Objective: The intermediate- to long-term use of psychostimulant medication has unclear benefits on the core symptoms of attention deficit hyperactivi ty disorder (ADHD) and delayed onset affective symptom side effects which c an mimic these core ADHD symptoms. 'ADHD and anxiety' has also been associa ted with a poor response to short-term psychostimulant medication treatment . In addition, it is unclear whether 'ADHD and anxiety' should be defined f rom the child's and/or the parent's perspective. We propose that anxiety wi ll be increased in children with ADHD who are treated with psychostimulant medication in the intermediate- to longterm who are identified by clinician s as poor responders. Method: Twenty children with ADHD who were medicated for 6 months or more a nd who had ongoing core symptoms of ADHD were compared to 20 age- and IQ-ma tched children with ADHD who were medication-naive. Chi-squared tests were performed on the categorical dependent variables and independent t-tests on the dependent continuous variables. Results: Anxiety is significantly increased in children with ADHD treated w ith psychostimulant medication in the intermediate- to long-term who are no ted by clinicians to have ongoing core symptoms of ADHD. This statistically significant finding is evident with both categorical and dimensional measu res of anxiety from the child's perspective. Conclusions: The recognition of anxiety and its management in children with ADHD is generally poorly understood. In this particular group of children with ADHD, anxiety may be a side effect of intermediate- to long-term psych ostimulant medication and/or a potential marker for a poor response to inte rmediate- to long-term psychostimulant medication treatment.