Sharp W S, Walter J M, Marsh W L, Ritchie G F, Hamburger S D, Castellanos F X
Child Psychiatry Branch, NIMH, Bethesda, MD, USA.
J Am Acad Child Adolesc Psychiatry. 1999 Jan;38(1):40-7. doi: 10.1097/00004583-199901000-00018.
The investigation of attention-deficit/hyperactivity disorder (ADHD) in girls raises complex questions of referral bias and selection criteria. The authors sought to determine whether they could recruit a research sample of comparably affected girls using a combination of sex-independent diagnostic criteria and sex-normed cutoffs on teacher ratings. They also report on the largest placebo-controlled crossover comparison of methylphenidate and dextroamphetamine in girls with ADHD.
Subjects were 42 girls with DSM-III-R/DSM-IV ADHD (combined type) contrasted to 56 previously studied boys with ADHD on comorbid diagnoses, behavioral ratings, psychological measures, psychiatric family history, and stimulant drug response.
Girls with ADHD were statistically indistinguishable from comparison boys on nearly all measures. Girls exhibited robust beneficial effects on both stimulants, with nearly all (95%) responding favorably to one or both drugs in this short-term trial. Dextroamphetamine produced significantly greater weight loss than methylphenidate.
This highly selected group of ADHD girls was strikingly comparable with comparison boys on a wide range of measures. The results confirm that girls with ADHD do not differ from boys in response to methylphenidate and dextroamphetamine and that both stimulants should be tried when response to the first is not optimal.
对女童注意力缺陷多动障碍（ADHD）的研究引发了关于转诊偏倚和选择标准的复杂问题。作者试图确定他们能否通过结合性别独立诊断标准和基于教师评分的性别规范临界值来招募受影响程度相当的女童研究样本。他们还报告了在患有ADHD的女童中进行的最大规模的哌甲酯与右旋苯丙胺安慰剂对照交叉比较研究。
研究对象为42名患有DSM-III-R/DSM-IV ADHD（混合型）的女童，并与56名先前研究过的患有ADHD的男童在共病诊断、行为评分、心理测量、精神科家族史及兴奋剂药物反应方面进行对比。
在几乎所有测量指标上，患有ADHD的女童与对照男童在统计学上无显著差异。女童对两种兴奋剂均表现出显著的有益效果，在这项短期试验中，几乎所有女童（95%）对其中一种或两种药物反应良好。右旋苯丙胺导致的体重减轻明显多于哌甲酯。
这一经过高度筛选的ADHD女童组在广泛的测量指标上与对照男童具有惊人的可比性。结果证实，患有ADHD的女童在对哌甲酯和右旋苯丙胺的反应上与男童无异，并且当对第一种药物反应不佳时，两种兴奋剂都应尝试使用。
