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哌醋甲酯治疗对 ADHD 儿童单独或合并对立违抗性障碍时的猜疑的影响。

The effect of methylphenidate treatment on suspiciousness in children with ADHD alone or comorbid with ODD.

机构信息

a Child and Adolescent Outpatient Clinic , Geha Mental Health Center , Petah Tikva , Israel.

c Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.

出版信息

Int J Psychiatry Clin Pract. 2018 Jun;22(2):109-114. doi: 10.1080/13651501.2017.1383436. Epub 2017 Sep 29.

Abstract

OBJECTIVE

To assess the level of the suspiciousness in children with attention deficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder (ODD) in comparison to ADHD alone and the response of suspiciousness symptoms to methylphenidate (MPH) treatment.

METHODS

In this open-label comparative study, children with DSM-IV-TR ADHD, aged 8-18 years, with (N = 30) or without (N = 30) ODD received MPH treatment for 12 weeks. The severity of ODD symptoms was assessed by the Kiddie-Schedule for Affective Disorders and Schizophrenia. The severity of ADHD symptoms was assessed by the ADHD-Rating-Scale-IV and suspiciousness was assessed at baseline and at endpoint by a scale designed especially for assessment of suspiciousness and named Suspiciousness Rating Scale (SRS).

RESULTS

Significant reductions in SRS scores were detected in both groups following MPH treatment (before and after: p = .0012 and p = .0273, respectively). Only in the ADHD/ODD group a significant correlation was found between the rate of improvement in ADHD, as assessed by the ADHD-RS, and the reduction in suspiciousness, as assessed by the SRS (Spearman r = 0.48, p =  .0066).

CONCLUSIONS

In addition to the beneficial effect of MPH treatment on ADHD and ODD symptoms it also diminishes suspiciousness. However, due to the small sample size further studies are needed to confirm the present results.

摘要

目的

评估伴有对立违抗障碍(ODD)的注意缺陷多动障碍(ADHD)儿童的可疑程度,并与单纯 ADHD 儿童进行比较,以及可疑症状对哌醋甲酯(MPH)治疗的反应。

方法

在这项开放标签的对照研究中,8-18 岁的 DSM-IV-TR ADHD 儿童(N=30)或不伴有 ODD(N=30)接受 MPH 治疗 12 周。ODD 症状的严重程度通过儿童心境障碍和精神分裂症评定量表评估。ADHD 症状的严重程度通过 ADHD 评定量表-IV 评估,可疑程度在基线和终点时通过专门设计的可疑量表评估,命名为可疑程度评定量表(SRS)。

结果

在 MPH 治疗后,两组的 SRS 评分均显著降低(治疗前后:p=0.0012 和 p=0.0273)。只有在 ADHD/ODD 组中,ADHD-RS 评估的 ADHD 改善率与 SRS 评估的可疑度降低之间存在显著相关性(Spearman r=0.48,p=0.0066)。

结论

除了 MPH 治疗对 ADHD 和 ODD 症状的有益作用外,它还可减轻可疑程度。然而,由于样本量小,需要进一步的研究来证实目前的结果。

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