Ghent University Academic Bibliography

Advanced

The impact of study design and diagnostic approach in a large multi-centre ADHD study: part 1: ADHD symptom patterns

Ueli C Muller, Philip Asherson, Tobias Banaschewski, Jan K Buitelaar, Richard P Ebstein, Jaques Eisenberg, Michael Gill, Iris Manor, Ana Miranda, Robert D Oades, et al. (2011) BMC PSYCHIATRY. 11.
abstract
Background: The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit/hyperactivity disorder (ADHD-CT) and 1446 'unselected' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods: Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results: Age and proband/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive/impulsive symptoms. Conclusions: Despite a symptom-based standardized inclusion procedure according to DSM-IV criteria with defined symptom thresholds, centres may differ markedly in probands' ADHD symptom frequencies. Both the diagnostic procedure and the multi-centre design influence the behavioural characteristics of a sample and, thus, may bias statistical analyses, particularly in genetic or neurobehavioral studies.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
ADHD, sibling design, informant effects, ATTENTION-DEFICIT/HYPERACTIVITY-DISORDER, ADHD multi-centre study, SCAN, FOLLOW-UP, QTL LINKAGE, TRANSPORTER GENE, DEFICIT HYPERACTIVITY DISORDER, GENOME-WIDE ASSOCIATION, CONDUCT DISORDER, PSYCHIATRIC COMORBIDITY, QUANTITATIVE TRAIT, centre effects
journal title
BMC PSYCHIATRY
BMC Psychiatry
volume
11
article number
54
pages
20 pages
Web of Science type
Article
Web of Science id
000289905300001
JCR category
PSYCHIATRY
JCR impact factor
2.552 (2011)
JCR rank
54/129 (2011)
JCR quartile
2 (2011)
ISSN
1471-244X
DOI
10.1186/1471-244X-11-54
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1968388
handle
http://hdl.handle.net/1854/LU-1968388
date created
2011-12-15 16:11:00
date last changed
2016-12-21 15:41:58
@article{1968388,
  abstract     = {Background: The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit/hyperactivity disorder (ADHD-CT) and 1446 'unselected' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods: Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results: Age and proband/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive/impulsive symptoms. Conclusions: Despite a symptom-based standardized inclusion procedure according to DSM-IV criteria with defined symptom thresholds, centres may differ markedly in probands' ADHD symptom frequencies. Both the diagnostic procedure and the multi-centre design influence the behavioural characteristics of a sample and, thus, may bias statistical analyses, particularly in genetic or neurobehavioral studies.},
  articleno    = {54},
  author       = {Muller, Ueli C and Asherson, Philip and Banaschewski, Tobias and Buitelaar, Jan K and Ebstein, Richard P and Eisenberg, Jaques and Gill, Michael and Manor, Iris and Miranda, Ana and Oades, Robert D and Roeyers, Herbert and Rothenberger, Aribert and Sergeant, Joseph A and Barke, Edmund and Thompson, Margaret and Faraone, Stephen V and Steinhausen, Hans-Christoph},
  issn         = {1471-244X},
  journal      = {BMC PSYCHIATRY},
  keyword      = {ADHD,sibling design,informant effects,ATTENTION-DEFICIT/HYPERACTIVITY-DISORDER,ADHD multi-centre study,SCAN,FOLLOW-UP,QTL LINKAGE,TRANSPORTER GENE,DEFICIT HYPERACTIVITY DISORDER,GENOME-WIDE ASSOCIATION,CONDUCT DISORDER,PSYCHIATRIC COMORBIDITY,QUANTITATIVE TRAIT,centre effects},
  language     = {eng},
  pages        = {20},
  title        = {The impact of study design and diagnostic approach in a large multi-centre ADHD study: part 1: ADHD symptom patterns},
  url          = {http://dx.doi.org/10.1186/1471-244X-11-54},
  volume       = {11},
  year         = {2011},
}

Chicago
Muller, Ueli C, Philip Asherson, Tobias Banaschewski, Jan K Buitelaar, Richard P Ebstein, Jaques Eisenberg, Michael Gill, et al. 2011. “The Impact of Study Design and Diagnostic Approach in a Large Multi-centre ADHD Study: Part 1: ADHD Symptom Patterns.” Bmc Psychiatry 11.
APA
Muller, U. C., Asherson, P., Banaschewski, T., Buitelaar, J. K., Ebstein, R. P., Eisenberg, J., Gill, M., et al. (2011). The impact of study design and diagnostic approach in a large multi-centre ADHD study: part 1: ADHD symptom patterns. BMC PSYCHIATRY, 11.
Vancouver
1.
Muller UC, Asherson P, Banaschewski T, Buitelaar JK, Ebstein RP, Eisenberg J, et al. The impact of study design and diagnostic approach in a large multi-centre ADHD study: part 1: ADHD symptom patterns. BMC PSYCHIATRY. 2011;11.
MLA
Muller, Ueli C, Philip Asherson, Tobias Banaschewski, et al. “The Impact of Study Design and Diagnostic Approach in a Large Multi-centre ADHD Study: Part 1: ADHD Symptom Patterns.” BMC PSYCHIATRY 11 (2011): n. pag. Print.