So Cheryl Y C, Leung Patrick W L, Hung Se-Fong
Kwai Chung Hospital, Hospital Authority, Hong Kong.
Behav Res Ther. 2008 Sep;46(9):983-92. doi: 10.1016/j.brat.2008.06.007. Epub 2008 Jun 27.
The effectiveness of a combined methylphenidate/behavioural treatment (BT) versus methylphenidate-only for Chinese children with Attention-Deficit/Hyperactivity Disorder (ADHD) was tested in routine clinical practice in Hong Kong.
A randomized group comparison design was adopted with two treatment conditions (methylphenidate-only; methylphenidate/BT), which lasted for 6 months. There were four assessment time points (pre-treatment, post-treatment, and 6-month and 12-month follow-ups), using the Strengths and Weaknesses of ADHD Symptoms and Normal Behaviours (SWAN) Rating Scale. Parental attitude toward different treatment options of ADHD was also assessed at pre-treatment and post-treatment. Participants included 90 Chinese ADHD children (mean age=8 years, SD=.95).
The combination of BT and a low-dose methylphenidate was significantly more effective than methylphenidate-only in reducing ADHD and ODD symptoms at post-treatment. At follow-ups, the benefits of the combined treatment were maintained, while the methylphenidate-only group caught up in improvement in ADHD symptoms. Parents in both treatment conditions showed improved attitude toward medication after the 6-month treatment phase, while their attitude toward BT was positive all along.
This study supported the added benefits of BT, on top of medication, for Chinese ADHD children in routine practice with treatments conducted by regular medical and paramedical staffs.
在香港的常规临床实践中,对哌甲酯联合行为治疗(BT)与仅使用哌甲酯治疗中国注意力缺陷/多动障碍(ADHD)儿童的有效性进行了测试。
采用随机分组比较设计,有两种治疗条件(仅哌甲酯;哌甲酯/BT),持续6个月。有四个评估时间点(治疗前、治疗后、6个月和12个月随访),使用ADHD症状与正常行为优缺点(SWAN)评定量表。在治疗前和治疗后还评估了父母对ADHD不同治疗方案的态度。参与者包括90名中国ADHD儿童(平均年龄 = 8岁,标准差 = 0.95)。
在治疗后,BT与低剂量哌甲酯联合使用在减轻ADHD和对立违抗性障碍(ODD)症状方面明显比仅使用哌甲酯更有效。在随访中,联合治疗的益处得以维持,而仅使用哌甲酯组在ADHD症状改善方面迎头赶上。在6个月治疗阶段后,两种治疗条件下的父母对药物治疗的态度都有所改善,而他们对BT的态度一直是积极的。
本研究支持在常规实践中,由正规医疗和辅助医疗人员进行治疗时,BT对中国ADHD儿童除药物治疗外的额外益处。