The Diagnosis and Treatment of Attention Deficit-Hyperactivity Disorder in Children and Adolescents with Cystic Fibrosis: A Retrospective Study

Background: There has been minimal study of the impact of attention deficit-hyperactivity disorder (ADHD) cystic fibrosis (CF) or other chronic illness. Objective: To examine patterns ADHD diagnosis and treatment in CF. Method: Retrospective chart review (if all pediatric patients in the Massachusetts General Hospital (MGH) CF: Program referred from 8/05-12/08 for outpatient child psychiatric consultation and diagnosed with ADHD). The medication trial resulting in the best improvement in ADHD. symptoins with the most tolerable side effects was designated the Best Regimen for each patient. Results: Of the 188 patients (wed 5-18 followed in the MGH CF Program during this time. IS (9.6%,;) were referred to the liaison psychiatrist and diagnosed with ADHD. Eleven (61%) had CF treatment non-adherence as a presenting problem. Psychopharmacologic treatment of AWL) was attempted in 13 of the IS cases. In eight eases the Best Regimen achieved Cl Clinical Global Impression improvement rating Of much or Very Mild, improved. In three cases. the Best Regimen consisted of stimulant monotherapy; two Consisted nonstimulant monotherapy: two used a combination of two nonstimulants; and one used a combination of nonstimulant and a nonstimulant. Conclusion: ADHD is common and treatable in pediatric patients with CF. Stimulants nonstimulans, and combination therapies are viable treatment options. The presence of ADHD or other psychiatric disorders should be considered when behavior. is interfering with adherence to medical care. Further research is needed into the prevalence and treatment of ADHD in CF and its impact on medical adherence and altleallles. ( Psychosomatics 2011: 52:160 196)