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长期使用哌甲酯和多模式心理社会治疗的多动症儿童的社会功能

Social functioning in children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment.

作者信息

Abikoff Howard, Hechtman Lily, Klein Rachel G, Gallagher Richard, Fleiss Karen, Etcovitch Joy, Cousins Lorne, Greenfield Brian, Martin Diane, Pollack Simcha

机构信息

NYU Child Study Center, New York University School of Medicine, New York, NY 10016, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 2004 Jul;43(7):820-9. doi: 10.1097/01.chi.0000128797.91601.1a.

Abstract

OBJECTIVE

To test that methylphenidate combined with intensive multimodal psychosocial intervention, which includes social skills training, significantly enhances social functioning in children with attention-deficit/hyperactivity disorder (ADHD) compared with methylphenidate alone and methylphenidate plus 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 (1) methylphenidate alone, (2) methylphenidate plus multimodal psychosocial treatment that included social skills training, or (3) methylphenidate plus attention control treatment. Assessments included parent, child, and teacher ratings of social function and direct school observations in gym.

RESULTS

No advantage was found on any measure of social functioning for the combination treatment over methylphenidate alone or methylphenidate plus attention control. Significant improvement occurred across all treatments and continued over 2 years.

CONCLUSIONS

In young children with ADHD, there is no support for clinic-based social skills training as part of a long-term psychosocial intervention to improve social behavior. Significant benefits from methylphenidate were stable over 2 years.

摘要

目的

测试与单独使用哌甲酯以及哌甲酯加非特异性心理社会治疗(注意力控制)相比,哌甲酯联合强化多模式心理社会干预(包括社交技能训练)是否能显著提高注意力缺陷多动障碍(ADHD)儿童的社交功能。

方法

103名患有ADHD(7 - 9岁)、无品行和学习障碍且对短期哌甲酯有反应的儿童被随机分组,接受为期2年的治疗:(1)单独使用哌甲酯;(2)哌甲酯加多模式心理社会治疗,包括社交技能训练;(3)哌甲酯加注意力控制治疗。评估包括家长、儿童和教师对社交功能的评分以及在体育馆进行的直接学校观察。

结果

在任何社交功能测量指标上,联合治疗相对于单独使用哌甲酯或哌甲酯加注意力控制均未显示出优势。所有治疗均有显著改善,且持续了2年。

结论

对于患有ADHD的幼儿,作为长期心理社会干预一部分的基于诊所的社交技能训练并不能改善社交行为。哌甲酯的显著益处持续了2年。

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