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首页> 外文期刊>The journal of clinical psychiatry >Moderators and mediators of symptoms and quality of life outcomes in an open-label study of adults treated for attention-deficit/hyperactivity disorder.
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Moderators and mediators of symptoms and quality of life outcomes in an open-label study of adults treated for attention-deficit/hyperactivity disorder.

机译：在一项针对注意力不足/多动症治疗的成年人的开放标签研究中，症状和生活质量结果的调节者和中介者。

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OBJECTIVE: The Quality of Life, Effectiveness, Safety, and Tolerability (QU.E.S.T.) study was designed to evaluate effectiveness of long-acting amphetamines in adults with attention-deficit/hyperactivity disorder (ADHD) in community practice settings. This article reports moderators and mediators of symptoms and quality of life outcomes. METHOD: This was an open-label study of 725 adults with DSM-IV-diagnosed ADHD, treated with mixed amphetamine salts extended release and followed for up to 8 months. Multiple regressions were used to determine if patient moderators impact response in ADHD symptoms and how ADHD symptoms and medication satisfaction mediate quality of life. The study was conducted from December 2003 to December 2004. RESULTS: Amphetamine treatment of ADHD resulted in a robust and enduring symptom response. Patient characteristics such as age, female gender, severity of illness, and treatment-naive status moderate improved symptom outcome. Symptom change and satisfaction with medication independently mediate change in mental but not physical quality of life outcomes. There is no time lag between changes in symptoms and improved quality of life. Attention is a stronger mediator of ADHD-specific quality of life outcomes than disruptive behavior. CONCLUSIONS: If symptoms and quality of life improve simultaneously, improvement in quality of life can be understood as more than just a downstream, secondary effect of symptom remission. Satisfaction with medication is a direct measure of the complex interplay of symptom change, tolerability, and patient perception of treatment that predicts self-report of quality of life benefits. Although the disruptive symptoms of ADHD are more obvious, adults self-report that attention has greater impact.
机译：目的：生活质量，有效性，安全性和耐受性（QU.E.S.T.）研究旨在评估长效苯丙胺在社区实践环境中对注意力不足/多动症（ADHD）成年人的有效性。本文报告症状和生活质量的调节者和中介者。方法：这是一项开放标签研究，研究对象是725名DSM-IV诊断为ADHD的成年人，用混合的苯丙胺盐盐缓释治疗，并随访8个月。使用多元回归来确定患者主持人是否影响多动症症状的反应，以及多动症症状和药物满意度如何介导生活质量。该研究于2003年12月至2004年12月进行。结果：苯丙胺对ADHD的治疗可产生强劲而持久的症状反应。患者的特征（例如年龄，女性，疾病的严重程度和未接受治疗的状态）可改善症状预后。症状的变化和对药物的满意度独立地介导了心理质量的变化，但没有介导生活质量的变化。症状变化与生活质量改善之间没有时间差。与多动症的行为相比，注意力是ADHD特定生活质量的更强中介。结论：如果症状和生活质量同时改善，则生活质量的改善不仅仅可以看作是症状缓解的下游，继发性影响。对药物的满意度是症状改变，耐受性和患者对治疗的感知之间复杂相互作用的直接量度，可预测患者对生活质量的自我报告。尽管多动症的破坏性症状更为明显，但成年人自我报告称注意力的影响更大。

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