Effects of Maternal Symptom Ratings and Other Clinical Features on Short-Term Treatment Response to OROS Methylphenidate in Children and Adolescents with ADHD in a Naturalistic Clinical Setting

Abstract

Objective To investigate the effect of Attention Deficit Hyperactivity Disorder (ADHD), antisocial behavior and anxiety/depression ratings of mothers, and child and adolescents’ age, gender, ADHD subtype, and comorbidity on one-month drug treatment response to OROS methylphenidate in ADHD in a naturalistic setting. Methods The analyses included 223 subjects (191 boys, 32 girls; age 6–15 years, mean: 9.4) treated with OROS methylphenidate (18–72 mg/day, mean: 31 mg/d; 0.4–1.4 mg/kg/d) for one-month. Treatment response was defined as larger than 25% or more decrease in pre-treatment the Conners Parent Rating Scale (CPRS) or the Conners Teacher Rating Scale (CTRS) total scores and the Clinical Global Impression improvement with drug treatment 3 (minimally improved) or higher. Maternal ADHD, antisocial behavior and anxiety/depression ratings were obtained by the Adult Self Rating (ASR). Logistic regression analyses were computed in order to calculate the effects of gender; age; ADHD subtype; comorbid anxiety disorder, learning disorder, oppositional defiant/conduct disorder; maternal ASR Anxiety/Depression, ADHD and Antisocial scores. Results 35.2% of subjects had statistically significant 25% or more decrease in pretreatment CPRS total scores and 38.6% of subjects had statistically significant 25% or more decrease in pretreatment CTRS total scores. The subjects with comorbid anxiety disorder had the poorest drug response. Maternal self-reported antisocial and anxiety/depressive symptomatology were statistically significantly associated with worse response to treatment in terms of CPRS (respectively, OR=0.83, 95% CI: 0.75–0.92, p<0.01; OR=0.95, 95% CI: 0.9–0.99, p<0.05) and CTRS total scores (OR=0.9, 95% CI: 0.82–0.99, OR=0.95, 95% CI: 0.91–1, p<0.05). Baseline rating scores were also important predictors of drug treatment response. Effects of age, gender and maternal ADHD were not statistically significant. Conclusion ADHD children and adolescents with comorbid anxiety disorders and those whose mothers have more self-reports of antisocial and depressive symptoms showed less favorable short-term response to OROS-MPH. These subjects may require further attention and additional interventions to augment treatment with OROS methylphenidate.

Parent-reported social problems and clinician-evaluated adverse effects may be differentially affected by differing extended release methylphenidate formulations: a prospective, naturalistic study from Turkey

“…Because, several prior studies suggested that baseline rating scores were important predictors of treatment response. This might be due to regression to the mean effect and implies that subjects with highest baseline scores have a higher chance of reduced post-treatment scores [30,31]. Baseline scores were higher in medikinet group and it may *% refers to percentage of subjects in whom the side effect was rated 1 or higher on the scale of the severity (1-9); %severe refers to the percentage of subjects in whom the side effect was rated 7 or higher.…”

Use of Electronic Entertainment and Communication Devices Among a Saudi Pediatric Population: Cross-Sectional Study

“…It was simply based on the mother’s overall impression of her child’s behavior. The accuracy of such global impressions has been proven to be effective in other studies [ 16 ]. Watching TV, which was most prevalent (154/190, 81.0%) in our sample, was previously noted by other investigators who found no association between watching TV and emotional symptoms, hyperactivity, inattention, or peer relationship problems [ 17 ].…”