Golubchik Pavel, Sever Jonathan, Zalsman Gil, Weizman Abraham
Child and Adolescent Outpatient Clinic, Geha Mental Health Center, Petah Tiqva, Israel.
Int Clin Psychopharmacol. 2008 Jul;23(4):228-31. doi: 10.1097/YIC.0b013e3282f94ae2.
Recent studies reported symptomatic overlap between attention deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD). Methylphenidate (MPH) is the most efficient treatment for ADHD. We assessed the efficacy and tolerability of MPH treatment in adolescent females who met the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria for both disorders. Fourteen BPD/ADHD female adolescents aged 14-19 years were treated with MPH for 12 weeks, targeting ADHD, BPD symptoms, and aggressive behavior, as rated by ADHD-rating scale (ADHD-RS) and Clinical Global Impression-Severity (CGI-S) scale for BPD and aggressive behavior severity. A significant improvement was detected in both ADHD and BPD severity (baseline vs. end point, ADHD-RS: 33.1+/-4.8 vs. 17.6+/-5.2, P<0.001; BPD CGI-S: 4.6+/-0.8 vs. 3.4+/-0.8, P<0.0005, respectively) as well as in aggressive behavior (Aggression CGI-S: 3.5+/-1.3 vs. 1.8+/-0.5, P<0.001). MPH was well tolerated. MPH may be useful and well tolerated in treating some shared symptoms of ADHD and BPD among female adolescents. Controlled studies are needed to substantiate these findings.
近期研究报告了注意力缺陷多动障碍(ADHD)与边缘型人格障碍(BPD)之间存在症状重叠。哌甲酯(MPH)是治疗ADHD最有效的药物。我们评估了MPH对符合《精神疾病诊断与统计手册》(DSM)-IV标准的两种疾病的青春期女性患者的疗效和耐受性。14名年龄在14 - 19岁的BPD/ADHD女性青少年接受了为期12周的MPH治疗,治疗目标为ADHD、BPD症状以及攻击行为,通过ADHD评定量表(ADHD-RS)以及BPD和攻击行为严重程度的临床总体印象-严重程度(CGI-S)量表进行评定。结果发现,ADHD和BPD的严重程度均有显著改善(基线与终点相比,ADHD-RS:33.1±4.8 vs. 17.6±5.2,P<0.001;BPD CGI-S:4.6±0.8 vs. 3.4±0.8,P<0.0005),攻击行为也有改善(攻击行为CGI-S:3.5±1.3 vs. 1.8±0.5,P<0.001)。MPH耐受性良好。MPH在治疗青春期女性ADHD和BPD的一些共同症状方面可能有效且耐受性良好。需要进行对照研究来证实这些发现。