Clinical and neuropsychological predictors of methylphenidate response in children and adolescents with ADHD: A naturalistic follow-up study in a spanish sample
| Autor: | Cesar Soutullo, Juan Jesús Marín-Méndez, Pilar de Castro-Manglano, Azucena Díez-Suárez, María Vallejo-Valdivielso |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Pediatrics
medicine.medical_specialty Epidemiology behavioral disciplines and activities 03 medical and health sciences 0302 clinical medicine mental disorders medicine Outpatient clinic ADHD Depressive symptoms business.industry Methylphenidate Neuropsychological variables Follow up studies Neuropsychology Cannabis use 030227 psychiatry Treatment Psychiatry and Mental health Clinical Practice Epidemiology in Mental Health Spanish sample Neuropsychological testing business 030217 neurology & neurosurgery Predictive factors Stroop effect medicine.drug |
| Zdroj: | Clinical Practice and Epidemiology in Mental Health : CP & EMH Dadun. Depósito Académico Digital de la Universidad de Navarra instname |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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