Harvard Medical School, Boston, MA, USA.
J Atten Disord. 2011 Jan;15(1):36-45. doi: 10.1177/1087054709356188. Epub 2010 Jan 13.
To determine the effects of long-term methylphenidate treatment on symptom severity and social adjustment in adult ADHD.
Adults (n = 116) meeting operational diagnostic criteria for ADHD (the "Utah Criteria") entered a randomized double-blind crossover trial of methylphenidate and placebo. Participants who improved on immediate-release methylphenidate entered a 12-month, open-label trial. Outcomes were assessed using the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS), Clinical Global Impression-Improvement (CGI-I), global assessment of functioning (GAF), and the Weissman Social Adjustment Scale (WSAS).
In the double-blind trial more patients improved (50% reduction of symptoms) receiving methylphenidate (74%) than placebo (21%, p = .001). During the open-label trial, symptom severity decreased 80% from baseline, and the WSAS decreased >50% in all subscales. The average GAF improved significantly (p < .0001).
ADHD adults, who responded to methylphenidate in a short-tem, placebo-controlled trial, responded to long-term treatment with marked improvements in ADHD symptoms and psychosocial functioning.
确定长期哌醋甲酯治疗对成人 ADHD 症状严重程度和社会适应的影响。
符合 ADHD（“犹他州标准”）操作性诊断标准的成年人（n = 116）进入了哌醋甲酯和安慰剂的随机双盲交叉试验。在即时释放哌醋甲酯治疗中改善的参与者进入了为期 12 个月的开放标签试验。使用 Wender-Reimherr 成人注意缺陷障碍量表（WRAADDS）、临床总体印象改善（CGI-I）、总体功能评估（GAF）和 Weissman 社会适应量表（WSAS）评估结果。
在双盲试验中，接受哌醋甲酯治疗的患者（74%）比安慰剂（21%）有更多的患者改善（症状减轻 50%，p =.001）。在开放标签试验中，症状严重程度从基线下降了 80%，WSAS 在所有子量表中都下降了>50%。平均 GAF 显著改善（p <.0001）。
在短期安慰剂对照试验中对哌醋甲酯有反应的 ADHD 成年人对长期治疗有反应，ADHD 症状和心理社会功能有显著改善。
