Departament of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
J Child Psychol Psychiatry. 2021 Jun;62(6):701-703. doi: 10.1111/jcpp.13374. Epub 2020 Dec 24.
In this issue, Rodrigues et al. (2020) present a systematic review with meta-analyses that reports the efficacy of five treatments for children with attention-deficit hyperactivity disorder symptoms in the context of autism spectrum disorder - (a) methylphenidate; (b) atomoxetine; (c) guanfacine; (d) aripiprazole; and (e) risperidone. In this commentary, we highlight the contrast between the scarce evidence base of treatment for ADHD in the context of autism and other subpopulations, such as tic disorders and intellectual disability, and the extensive evidence base of treatment for ADHD in general. The commentary weighs about the conundrum clinicians face of whether to rely on the limited evidence base of treatment for ADHD in subpopulation, or to derive conclusions from the larger body of evidence of treatment for ADHD in general. The commentary also discusses potential avenues for future research to address this clinical problem.
在本期中，Rodrigues 等人（2020 年）进行了一项系统评价和荟萃分析，报告了五种治疗自闭症谱系障碍儿童注意缺陷多动障碍症状的疗效 - (a) 哌醋甲酯；(b) 托莫西汀；(c) 胍法辛；(d) 阿立哌唑；和 (e) 利培酮。在这篇评论中，我们强调了自闭症谱系障碍以及其他亚群（如抽动障碍和智力残疾）中治疗 ADHD 的证据基础稀缺与 ADHD 一般治疗的广泛证据基础之间的对比。该评论权衡了临床医生面临的困境，即是否依赖 ADHD 亚群治疗的有限证据基础，还是从 ADHD 一般治疗的更大证据体中得出结论。该评论还讨论了未来研究解决这一临床问题的潜在途径。
