Methylphenidate effects on functional outcomes in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS)
Methylphenidate effects on functional outcomes in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS)
复制标题
DOI：
10.1089/cap.2007.0068
复制
发表时间：
2007-11-01
影响因子：
1.9
通讯作者：
Wigal, Tim
中科院分区：
文献类型：
--
作者：
Abikoff, Howard B.;Vitiello, Benedetto;Wigal, Tim
目的：本研究的目的是在为期4周的双盲安慰剂对照的学龄前儿童注意缺陷多动障碍（ADHD）治疗研究（PATS）中，研究哌甲酯（MPH）对儿童功能结果的影响，包括儿童的社交技能、课堂行为、情绪状态和父母压力。共有114名学龄前儿童在急性MPH治疗后得到改善，他们被随机分配到最佳MPH剂量组（M = 14.22 mg/d; n = 63）或安慰剂组（PL; n = 51）。采用临床总体印象量表（CGI-S）、家长版和教师版ADHD症状和正常行为量表（SWAN）、社会能力量表（SCS）、社会技能评定系统（SSRS）、儿童早期量表（ECI）和父母压力指数（PSI）进行评估。家长措施和教师SWAN分数没有显着改善MPH。父母评定的抑郁（p = 0.02）和恶劣心境（p = 0.001）的ECI恶化与MPH，但分数不在临床范围内。临床医生CGI-S（p = 0.0001）和教师社会能力评级（SCS，p = 0.03）上发现显着的药物效果。结论：学龄前儿童多动症与MPH治疗4周，在某些方面的功能改善。进一步的改善可能需要更长的治疗时间，更高的剂量，和/或强化行为治疗与药物相结合。
Objective: The purpose of this study was to examine the effects of methylphenidate (MPH) on functional outcomes, including children's social skills, classroom behavior, emotional status, and parenting stress, during the 4-week, double-blind placebo controlled phase of the Preschoolers with Attention Deficit/ Hyperactivity Disorder (ADHD) Treatment Study (PATS).Methods: A total of 114 preschoolers who had improved with acute MPH treatment, were randomized to their best MPH dose (M = 14.22 mg/day; n = 63) or placebo (PL; n = 51). As-sessments included the Clinical Global Impression-Severity (CGI-S), parent and teacher versions of the Strengths and Weaknesses of ADHD-Symptoms and Normal Behaviors (SWAN), Social Competence Scale (SCS), Social Skills Rating System (SSRS), and Early Childhood Inventory (ECI), and Parenting Stress Index (PSI).Results: Medication effects varied by informant and outcome measure. Parent measures and teacher SWAN scores did not differentially improve with MPH. Parent-rated depression (p = 0.02) and dysthymia (p = 0.001) on the ECI worsened with MPH, but scores were not in the clinical range. Significant medication effects were found on clinician CGI-S (p = 0.0001) and teacher social competence ratings (SCS, p = 0.03).Conclusions: Preschoolers with ADHD treated with MPH for 4 weeks improve in some aspects of functioning. Additional improvements might require longer treatment, higher doses, and/or intensive behavioral treatment in combination with medication.