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首页> 外文期刊>Clinical practice and epidemiology in mental health >Clinical and Neuropsychological Predictors of Methylphenidate Response in Children and Adolescents with ADHD: A Naturalistic Follow-up Study in a Spanish Sample
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Clinical and Neuropsychological Predictors of Methylphenidate Response in Children and Adolescents with ADHD: A Naturalistic Follow-up Study in a Spanish Sample

机译：多动症儿童和青少年的哌醋甲酯反应的临床和神经心理学预测因素：西班牙样本中的自然随访研究

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Background: Methylphenidate (MPH) is the most commonly used medication for Attention-Deficit/Hyperactivity Disorder (ADHD), but to date, there are neither consistent nor sufficient findings on conditions differentiating responsiveness to MPH response in ADHD. Objective: To develop a predictive model of MPH response, using a longitudinal and naturalistic follow-up study, in a Spanish sample of children and adolescents with ADHD. Methods: We included all children and adolescents with ADHD treated with MPH in our outpatient Clinic (2005 to 2015), evaluated with the K-SADS interview. We collected ADHD-RS-IV.es and CGI-S scores at baseline and at follow up, and neuropsychological testing (WISC-IV, Continuous Performance Test (CPT-II) & Stroop). Clinical response was defined as 30% reduction from baseline of total ADHD-RS-IV.es score and CGI-S final score of 1 or 2 maintained for the previous 3 months. Results: We included 518 children and adolescents with ADHD, mean (SD) age of patients was 11.4 (3.3) years old; 79% male; 51.7% had no comorbidities; and 75.31% had clinical response to a mean MPH dose of 1.2 mg/kg/day. Lower ADHD-RS-IV.es scores, absence of comorbidities (oppositional-defiant symptoms, depressive symptoms and alcohol/cannabis use), fewer altered neuropsychological tests, higher total IQ and low commission errors in CPT-II, were significantly associated with a complete clinical response to methylphenidate treatment. Conclusion: Oppositional-defiant symptoms, depressive symptoms, and a higher number of impaired neuropsychological tests are associated with worse clinical response to methylphenidate. Other stimulants or non-stimulants treatment may be considered when these clinical and neuropsychological variables converged in the first clinical interview.
机译：背景：哌醋甲酯（MPH）是引起注意力缺陷/多动障碍（ADHD）的最常用药物，但迄今为止，在区分ADHD对MPH反应的反应条件方面，尚无一致或充分的发现。目的：在西班牙多动症儿童和青少年样本中，通过纵向和自然随访研究，建立MPH反应的预测模型。方法：我们将所有接受MPH治疗的ADHD儿童和青少年纳入我们的门诊（2005年至2015年），并通过K-SADS访谈进行了评估。我们收集了基线和随访时的ADHD-RS-IV.es和CGI-S分数，以及神经心理学测试（WISC-IV，持续表现测试（CPT-II）和Stroop）。临床反应定义为在过去3个月中，总ADHD-RS-IV.es得分和CGI-S最终得分分别为1或2降低了30％以上。结果：我们纳入了518名患有ADHD的儿童和青少年，患者的平均（SD）年龄为11.4（3.3）岁; 79％男性; 51.7％无合并症; 75.31％的人对平均MPH剂量为1.2 mg / kg /天有临床反应。 ADHD-RS-IV.es评分较低，无合并症（对立挑衅症状，抑郁症状和饮酒/大麻使用），神经心理测验变化少，CPT-II的总智商高和佣金低均与以下症状显着相关：对哌醋甲酯治疗有完整的临床反应。结论：相反的症状，抑郁的症状和大量的神经心理测试受损与对哌醋甲酯的较差临床反应有关。当这些临床和神经心理学变量在首次临床访谈中趋于一致时，可以考虑使用其他兴奋剂或非兴奋剂治疗。

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