Tannock R, Ickowicz A, Schachar R
Department of Psychiatry-Research Unit, Hospital for Sick Children, Toronto, Ontario, Canada.
J Am Acad Child Adolesc Psychiatry. 1995 Jul;34(7):886-96. doi: 10.1097/00004583-199507000-00012.
To examine the effects of methylphenidate (MPH) on working memory and behavior in anxious and nonanxious children with attention-deficit hyperactivity disorder (ADHD).
A total of 40 ADHD children (22 nonanxious, 18 anxious) completed a randomized, double-blind, placebo-controlled, crossover trial with three doses (0.3, 0.6, 0.9 mg/kg) of MPH. A serial addition task was used to assess working memory; direct observation of motor activity indexed behavior.
MPH improved working memory in the nonanxious ADHD group but not in the comorbidity anxious group. By contrast, MPH reduced activity level in both groups. The presence of concurrent learning disabilities did not influence stimulant response.
The presence of comorbid anxiety in children with ADHD predicts a less robust response to stimulant treatment and suggests that ADHD with anxiety may constitute a distinct and clinically meaningful subtype of ADHD.
研究哌甲酯（MPH）对患有注意力缺陷多动障碍（ADHD）的焦虑和非焦虑儿童工作记忆及行为的影响。
共有40名ADHD儿童（22名非焦虑儿童，18名焦虑儿童）完成了一项随机、双盲、安慰剂对照、交叉试验，试验使用了三种剂量（0.3、0.6、0.9毫克/千克）的MPH。采用连续加法任务评估工作记忆；通过直接观察运动活动来衡量行为。
MPH改善了非焦虑ADHD组的工作记忆，但对合并焦虑症的组没有效果。相比之下，MPH降低了两组的活动水平。同时存在学习障碍并不影响兴奋剂反应。
ADHD儿童合并焦虑症预示着对兴奋剂治疗的反应较弱，并表明伴有焦虑症的ADHD可能构成ADHD一种独特且具有临床意义的亚型。
