Long-term stimulant medication treatment of attention-deficit/hyperactivity disorder: Results from a population-based study
Long-term stimulant medication treatment of attention-deficit/hyperactivity disorder: Results from a population-based study
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DOI：
10.1097/00004703-200602000-00001
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发表时间：
2006-02-01
影响因子：
2.4
通讯作者：
Jacobsen, SJ
中科院分区：
文献类型：
--
作者：
Barbaresi, WJ;Katusic, SK;Jacobsen, SJ
这项研究的目的是提供关于在1976-1982年间明尼苏达州罗切斯特市出生队列中379名患有注意力缺陷多动障碍(ADHD)的儿童在整个童年期间接受兴奋剂治疗的详细信息。研究对象从出生到平均年龄为17.2岁。对每个受试者的完整医疗记录进行了复习。通过性别、ADHD的DSM-IV亚型和刺激性药物的类型来比较每一次刺激性治疗的病史和结果。总体而言，77.8%的受试者接受了兴奋剂治疗。男孩接受治疗的可能性是女孩的1.8倍。开始治疗的中位年龄(9.8岁)、中位治疗持续时间(33.8个月)和出现至少一种副作用的可能性(22.3%)在性别上没有显著差异。总体而言，73.1%的刺激性治疗事件与良好反应有关。男孩和女孩获得积极回应的可能性是相当的。ADHD混合型或ADHD多动-冲动型儿童较注意力不集中为主的ADHD儿童更早开始治疗，且治疗时间较长。DSM-IV亚型与良好反应或副作用的可能性之间没有关联。右旋苯丙胺和哌醋甲酯同样可能与良好反应有关，但右旋苯丙胺更有可能与副作用有关。这些结果表明，在整个儿童时期提供的兴奋剂治疗ADHD的疗效与临床试验中证明的兴奋剂治疗的疗效相当。
The purpose of this study was to offer detailed information about stimulant medication treatment provided throughout childhood to 379 children with research-identified attention-deficit hyperactivity disorder (ADHD) in the 1976-1982 Rochester, MN, birth cohort. Subjects were retrospectively followed from birth until a mean of 17.2 years of age. The complete medical record of each subject was reviewed. The history and results of each episode of stimulant treatment were compared by gender, DSM-IV subtype of ADHD, and type of stimulant medication. Overall, 77.8% of subjects were treated with stimulants. Boys were 1.8 times more likely than girls to be treated. The median age at initiation (9.8 years), median duration of treatment (33.8 months), and likelihood of developing at least one side effect (22.3%) were not significantly different by gender. Overall, 73.1% of episodes of stimulant treatment were associated with a favorable response. The likelihood of a favorable response was comparable for boys and girls. Treatment was initiated earlier for children with either ADHD combined type or ADHD hyperactive-impulsive type than for children with ADHD predominantly inattentive type and duration of treatment was longer for ADHD combined type. There was no association between DSM-IV subtype and likelihood of a favorable response or of side effects. Dextroamphetamine and methylphenidate were equally likely to be associated with a favorable response, but dextroamphetamine was more likely to be associated with side effects. These results demonstrate that the effectiveness of stimulant medication treatment of ADHD provided throughout childhood is comparable to the efficacy of stimulant treatment demonstrated in clinical trials.