Academic achievement and emotional status of children with ADHD treated with long-term methylphenidate psychosocial and multimodal treatment
Academic achievement and emotional status of children with ADHD treated with long-term methylphenidate psychosocial and multimodal treatment
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DOI：
10.1097/01.chi.0000128796.84202.eb
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发表时间：
2004-07-01
影响因子：
13.3
通讯作者：
Pollack, S
中科院分区：
文献类型：
--
作者：
Hechtman, L;Abikoff, H;Pollack, S
目的：验证强化多模式社会心理干预（包括学业援助和心理治疗）联合哌醋甲酯与单独使用哌醋甲酯和哌醋甲酯联合非特异性社会心理治疗（注意控制）相比，显著提高注意缺陷/多动障碍（ADHD）儿童的学习成绩和情绪状态的假设。方法：103名无行为障碍和学习障碍的儿童（7-9岁），对短期哌醋甲酯有反应，随机选择2年，接受以下三种治疗之一：(1)哌醋甲酯单独治疗，(2)哌醋甲酯加心理治疗，包括学业补习、组织能力训练、心理治疗以及父母培训、咨询和社交技能训练，或(3)哌醋甲酯加注意力控制治疗。通过学业测试、家长对家庭作业问题的评分、抑郁和自尊的自我评分来评估儿童的功能。结果;在学业成绩或情绪状态方面，联合治疗没有发现比单独使用哌甲酯和哌甲酯加注意力控制更有优势。所有治疗均有显著改善，并维持2年以上。结论：在没有学习和行为障碍的兴奋剂反应性ADHD幼儿中，不支持学习辅助和心理治疗来提高学习成绩或情绪调节。显著的短期改善持续了2年。
Objective: To test the hypothesis that intensive multimodal psychosocial intervention (that includes academic assistance and psychotherapy) combined with methylphenidate significantly enhances the academic performance and emotional status of children with attention-deficit/hyperactivity disorder (ADHD) compared with methylphenidate alone and with methylphenidate combined with nonspecific psychosocial treatment (attention control). Method: One hundred three children with ADHD (ages 7-9), free of conduct and learning disorders, who responded to short-term methylphenidate were randomized for 2 years to receive one of three treatments: (1) methylphenidate alone, (2) methylphenidate plus psychosocial treatment that included academic remediation, organizational skills training, and psychotherapy as well as parent training and counseling and social skills training, or (3) methylphenidate plus attention control treatment. Children's function was assessed through academic testing, parent ratings of homework problems, and self-ratings of depression and self-esteem. Results; No advantage was found on any measure of academic performance or emotional status for the combination treatment over methylphenidate alone and over methylphenidate plus attention control. Significant improvement occurred across all treatments and was maintained over 2 years. Conclusions: In stimulant-responsive young children with ADHD without learning and conduct disorders, there is no support for academic assistance and psychotherapy to enhance academic achievement or emotional adjustment. Significant short-term improvements were maintained over 2 years.