Attention Deficit Hyperactivity Disorder (ADHD) - Impact of Comorbid Anxiety and Pharmacological Mediation with a Noradrenergic Reuptake Inhibitor, Atomoxetine

Abstract

The collected works of this thesis represent a progression of the ideas and aspirations of a group of long standing collaborators and friends, with whom the candidate has worked over the last 20 years. The opening sections of this thesis provide information required to fulfil reporting requirements and provide summary details of the structure of this thesis. Chapter 1 details background information on attention deficit-hyperactivity disorder (ADHD), the clinical condition studied; and atomoxetine, the treatment medication. The chapter provides the rationale for examining outcomes from treatment of ADHD with a noradrenergic medication, and concludes describing the hypothesis and aims of the thesis. The second chapter details the methods of inquiry. The thesis hypotheses and aims were formally embedded in a project grant application which was funded by the National Health and Medical Research Council (NHMRC). Data used in this study forms a subset of the ACTION study data set. The ACTION study aimed to determine: 1) if atomoxetine has efficacy for improving cognition and emotional processing; and 2) if response to atomoxetine is predicted by other measures of cognition or emotion in ADHD Chapter 3 highlights the different measures of anxiety, including patient, parent and clinician reported measures, and provides justification for selecting a parent-rated measure to assess change in anxiety in the present study. Chapters 3 and 4 report outcomes defining the relationship between ADHD and anxiety in the study cohort, the impact of treatment with atomoxetine on behaviour and cognition, and an integration of outcomes between measures of behaviour, cognition and anxiety. The final chapter provides a synopsis of these outcomes and provides a context in which further investigation may proceed to increase understanding of the aetiology of ADHD and establishes a rationale to personalise and improve treatment of this condition.