Smith B H, Pelham W E, Gnagy E, Yudell R S
Attention Deficit Disorder Program, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, USA.
J Am Acad Child Adolesc Psychiatry. 1998 Mar;37(3):314-21. doi: 10.1097/00004583-199803000-00017.
To compare the therapeutic effect size of methylphenidate on attention-deficit hyperactivity disorder (ADHD) during childhood versus adolescence.
A retrospective follow-up study of 16 individuals with diagnosed ADHD who completed double-blind, placebo-controlled, crossover studies of methylphenidate 0.3 mg/kg during two separate summer treatment programs. The programs were completed when the subjects were children (aged 8 to 11 years) and adolescents (aged 12 to 14.5 years). Dependent variables include objective measures of academic performance and social behavior and ratings completed by counselors and teachers.
Effect sizes ranged from very large to small, with most effects in the moderate to large range. Across the 12 dependent variables, t tests found that only 3 showed statistically significant changes in effect size from childhood to adolescence. Putative changes in effect sizes can be dismissed for methodological reasons.
Stimulant medication is equally effective with children and adolescents with ADHD if they are engaged in similar activities. Treatment providers should rigorously examine environmental causes to problems before prescribing higher doses of stimulants to adolescents with ADHD who exhibit a worsening in functioning.
比较哌甲酯对儿童期与青少年期注意力缺陷多动障碍（ADHD）的治疗效应大小。
对16名确诊为ADHD的个体进行回顾性随访研究，这些个体在两个独立的夏季治疗项目中完成了哌甲酯0.3mg/kg的双盲、安慰剂对照、交叉研究。项目在受试者为儿童（8至11岁）和青少年（12至14.5岁）时完成。因变量包括学业成绩和社会行为的客观测量以及咨询师和教师完成的评分。
效应大小范围从非常大到小，大多数效应在中等至大的范围内。在12个因变量中，t检验发现只有3个在从儿童期到青少年期的效应大小上显示出统计学上的显著变化。由于方法学原因，效应大小的假定变化可以被忽略。
如果患有ADHD的儿童和青少年参与类似活动，则兴奋剂药物对他们同样有效。治疗提供者在为功能恶化的ADHD青少年开更高剂量的兴奋剂之前，应严格检查问题的环境原因。
