Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Psychiatr Res. 2021 Oct;142:204-209. doi: 10.1016/j.jpsychires.2021.07.055. Epub 2021 Aug 2.
Long-term effects of ADHD medication on cognitive functions are not well known. This study investigates development of cognitive functions and ADHD symptoms on well-controlled medication for 1 year in children and adolescents.
This study is part of an ongoing open uncontrolled trial of long-term medication for ADHD in children and adolescents aged 6-18 years with any form of ADHD, and frequently comorbid autism spectrum disorder (ASD, 29%) or autistic traits (24%). Other comorbidities were oppositional defiant disorder, dyslexia/language disorder, borderline intellectual functioning, developmental coordination disorder. This analysis includes 87 participants (61 boys, 26 girls) who completed Wechsler tests at baseline and after 12 months. ADHD symptoms were investigator-rated on the ADHD Rating Scale-IV at the same time points.
The whole group of children and adolescents showed significant improvements in Wechsler Full Scale IQ (FSIQ, mean at baseline 92.6, at 12 months 97.95), and on the Index Scales Verbal Comprehension, Working Memory and Processing Speed, after one year of well-controlled ADHD medication. Comorbid dyslexia/language impairment predicted a larger rise in FSIQ, but not gender, ADHD presentation or comorbid ASD. Robust improvements in ADHD symptoms were observed (mean ADHD-Rating Scale score at baseline 34.6, and at 12 months 18.3).
Cognitive test scores and ADHD symptoms were improved on well-controlled medication for 1 year in children and adolescents with ADHD, autism and other comorbidities. The main study limitation is the open uncontrolled trial design.
ADHD 药物治疗对认知功能的长期影响尚不清楚。本研究旨在调查在儿童和青少年接受长达 1 年的良好控制药物治疗后，认知功能和 ADHD 症状的发展情况。
这是一项正在进行的儿童和青少年 ADHD 长期药物治疗的开放性非对照试验的一部分，纳入任何形式的 ADHD 患儿和青少年（6-18 岁），共 29%存在自闭症谱系障碍（ASD），24%存在自闭症特质。其他合并症为对立违抗性障碍、诵读困难/语言障碍、边缘智力功能、发育性协调障碍。本分析包括 87 名完成基线和 12 个月时韦氏测试的参与者（61 名男孩，26 名女孩）。在同一时间点，根据 ADHD 评定量表-IV 评估 ADHD 症状。
在经过 1 年的良好控制 ADHD 药物治疗后，所有儿童和青少年的韦氏全量表智商（FSIQ）均显著提高（基线时平均值为 92.6，12 个月时为 97.95），言语理解、工作记忆和处理速度指数也显著提高。合并诵读困难/语言障碍预测 FSIQ 升高幅度更大，但性别、ADHD 表现或合并 ASD 无此预测作用。ADHD 症状也有显著改善（基线时平均 ADHD 评定量表得分为 34.6，12 个月时为 18.3）。
在患有 ADHD、自闭症和其他合并症的儿童和青少年中，经过 1 年的良好控制药物治疗后，认知测试分数和 ADHD 症状均有改善。本研究的主要局限性在于开放性非对照试验设计。
