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多动症中哌甲酯的治疗反应:儿童及观察者性别的作用

Therapeutic Response to Methylphenidate in ADHD: Role of Child and Observer Gender.

作者信息

Bhat Venkat, Sengupta Sarojini M, Grizenko Natalie, Joober Ridha

机构信息

Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario.

Department of Psychiatry, University of Toronto, Toronto, Ontario.

出版信息

J Can Acad Child Adolesc Psychiatry. 2020 Mar;29(1):44-52. Epub 2020 Mar 1.

Abstract

OBJECTIVE

This study aims to examine the interaction between the gender of the child and the gender of the observers (teachers, parents) on the therapeutic response (TR) noted with methylphenidate (MPH) in children with ADHD.

METHOD

Children with ADHD participated in a two week double-blind, randomized, cross-over clinical trial with MPH and placebo, and the difference between the week of treatment with MPH and placebo was calculated for each measure to obtain the treatment response (TR) with MPH. The TR for differences based on the gender of child and the observer was examined by using a univariate analysis of covariance (ANCOVA).

RESULTS

299 children (269-male, 30-female; average age 8.9±1.8 years) were evaluated by 52 male teachers, 212 female teachers; 269 female parents and 30 male parents. For the baseline week, the ANCOVA analysis for teachers yielded a significant teacher's gender x child's gender interaction. For the evaluation of TR, the ANCOVA analysis revealed a significant teacher's gender x child's gender interaction whereas no parent's gender x child's gender interactions were noted, all noted interactions were of a small effect size (eta squared <0.02).

CONCLUSIONS

These results suggest that there are differences in symptom assessment between parents and teachers at baseline and with TR based on the gender of the observer and the child. While clinicians need to be aware of these interactions, it remains unclear if these interactions will be clinically useful due to the small effect sizes.

摘要

目的

本研究旨在探讨患有注意力缺陷多动障碍(ADHD)的儿童性别与观察者(教师、家长)性别之间的相互作用对使用哌甲酯(MPH)治疗反应(TR)的影响。

方法

患有ADHD的儿童参与了一项为期两周的双盲、随机、交叉临床试验,分别使用MPH和安慰剂,计算出使用MPH治疗周与使用安慰剂周各项指标的差异,以获得MPH的治疗反应(TR)。通过单因素协方差分析(ANCOVA)研究基于儿童性别和观察者性别的差异的TR。

结果

299名儿童(269名男性,30名女性;平均年龄8.9±1.8岁)由52名男教师、212名女教师、269名女家长和30名男家长进行评估。在基线周,针对教师的ANCOVA分析显示教师性别×儿童性别存在显著交互作用。对于TR评估,ANCOVA分析显示教师性别×儿童性别存在显著交互作用,而未发现家长性别×儿童性别存在交互作用,所有观察到的交互作用效应量均较小(偏 eta 方<0.02)。

结论

这些结果表明,在基线时以及基于观察者和儿童性别的TR方面,家长和教师在症状评估上存在差异。虽然临床医生需要了解这些相互作用,但由于效应量较小,这些相互作用是否具有临床实用性仍不清楚。

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