Cook J R, Mausbach T, Burd L, Gascon G G, Slotnick H B, Patterson B, Johnson R D, Hankey B, Reynolds B W
Psychology Department, Royal Jubilee Hospital, Victoria, British Columbia.
J Psychiatry Neurosci. 1993 May;18(3):130-7.
Fifteen boys aged six to ten who met the criteria for attention deficit disorder (ADD) were compared with ten boys who did not have ADD in a double-blind, placebo-controlled, single-crossover study of methylphenidate. To assess the degree of overlap between ADD and central auditory processing disorder (CAPD), all subjects were assessed on parent and teacher behavior rating scales, as well as a battery of CAPD tests at baseline and after three and six weeks of treatment. Twelve of the 15 subjects with ADD and none of the subjects without ADD met the criteria for CAPD. The subjects with ADD also responded to stimulant treatment on the measures of both ADD and CAPD. The overlap in the symptomatology of these disorders, the finding that the criteria for both disorders were met in 12 of 15 cases and the sensitivity of both ADD and CAPD measures to treatment with methylphenidate suggest that ADD and CAPD are closely related disorders. The implications of these results are three-fold. First, sustained attention is a critical feature of performance on CAPD tests and the current diagnostic criteria for CAPD make a clinical separation of the two disorders problematic. Second, stimulants appear to be a useful treatment for the symptoms of both ADD and CAPD. Third, CAPD tests may be a useful measure of ADD symptomatology and response to stimulants.
在一项关于哌甲酯的双盲、安慰剂对照、单交叉研究中,将15名年龄在6至10岁且符合注意力缺陷障碍(ADD)标准的男孩与10名无ADD的男孩进行了比较。为了评估ADD与中枢听觉处理障碍(CAPD)之间的重叠程度,在基线以及治疗3周和6周后,对所有受试者进行了家长和教师行为评定量表评估以及一系列CAPD测试。15名患有ADD的受试者中有12名符合CAPD标准,而无ADD的受试者中无人符合该标准。患有ADD的受试者在ADD和CAPD测量指标上对兴奋剂治疗也有反应。这些疾病症状学上的重叠、15例中有12例同时符合两种疾病标准的发现以及ADD和CAPD测量指标对哌甲酯治疗的敏感性表明,ADD和CAPD是密切相关的疾病。这些结果的影响有三个方面。第一,持续注意力是CAPD测试表现的关键特征,目前CAPD的诊断标准使得这两种疾病在临床上难以区分。第二,兴奋剂似乎是治疗ADD和CAPD症状的有效方法。第三,CAPD测试可能是评估ADD症状学和对兴奋剂反应的有用指标。