Department of Psychiatry, University of Florida, P.O. Box 100234, Gainesville, FL 32610, USA.
J Atten Disord. 2011 Jul;15(5):382-91. doi: 10.1177/1087054710367772. Epub 2010 May 21.
To investigate the extent to which children with ADHD in various medication statuses (i.e., medication naïve, pure stimulant, stimulant plus another medication, nonstimulants) varied on cognitive or academic, behavioral, and social functioning during a psychoeducational assessment battery.
Participants for this study consisted of 66 children (20 girls) with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) diagnosis of ADHD confirmed by a comprehensive clinical diagnostic assessment, including the use of a semistructured interview and Conners' Parent Rating Scales. Standardized cognitive and academic measures along with parent report of medication status, behavioral, and social functioning were collected.
No differences were found among children in the various medication groups in terms of ADHD symptoms severity, academic performance, processing speed, verbal abilities, or perceptual reasoning skills. However, children in the medication-naïve group performed significantly better than the stimulant-plus-another-medication and nonstimulant groups in terms of overall cognitive abilities, working-memory skills, and social adaptability but had similar scores to children in the pure-stimulant group. Children in the pure-stimulant group also had marginally higher working-memory scores compared to children in the nonstimulant group but not compared to the stimulant-plus-another-medication group. The pure-stimulant group also had significantly lower externalizing and internalizing problems and higher social adaptability compared to the stimulant-plus-another-medication group but not compared to the medication-naïve or nonstimulant groups.
Findings showed evidence for distinct cognitive, behavioral, and social profiles among children with ADHD who are proactively not on medication, as well as differences among children with ADHD who are on only one stimulant versus a nonstimulant or stimulant-plus-another-medication regimen.
研究在心理教育评估工具包中，处于不同药物治疗状态（即未经药物治疗、单纯兴奋剂、兴奋剂加另一种药物、非兴奋剂）的 ADHD 儿童在认知或学业、行为和社会功能方面的差异程度。
本研究的参与者包括 66 名儿童（20 名女孩），他们被诊断患有注意力缺陷多动障碍（ADHD），符合《精神障碍诊断与统计手册》（第 4 版）（DSM-IV）的标准，并通过全面的临床诊断评估得到确认，包括使用半结构化访谈和康纳斯父母评定量表。收集了标准化的认知和学业测量以及家长报告的药物治疗状态、行为和社会功能。
在 ADHD 症状严重程度、学业成绩、加工速度、言语能力或知觉推理技能方面，不同药物治疗组的儿童之间没有差异。然而，未经药物治疗组的儿童在总体认知能力、工作记忆技能和社会适应性方面的表现明显优于兴奋剂加另一种药物组和非兴奋剂组，但与单纯兴奋剂组的儿童得分相似。单纯兴奋剂组的儿童在工作记忆方面的得分也略高于非兴奋剂组，但与兴奋剂加另一种药物组的儿童相比则没有差异。单纯兴奋剂组的儿童在外部和内部问题以及社会适应性方面也明显低于兴奋剂加另一种药物组，但与未经药物治疗或非兴奋剂组相比则没有差异。
研究结果表明，积极不接受药物治疗的 ADHD 儿童在认知、行为和社会方面具有不同的特征，而且只接受一种兴奋剂与接受非兴奋剂或兴奋剂加另一种药物的 ADHD 儿童之间也存在差异。
