Objective Versus Subjective Assessment of Methylphenidate Response

Abstract

Subjective improvement-assessment in attention deficit/hyperactivity disorder (ADHD), following a single dose of methylphenidate (MPH) was compared to performance on the Test-of-Variables-of-Attention (TOVA). Self-perception was assessed with the clinical-global-impression-of-change (CGI-C). Participants included 165 ADHD subjects (M:F ratio 67%:33%) aged 5-18 (11.09 +/- 3.43) years. TOVA was administered before and after MPH challenge (0.3 mg/kg). Self-perception CGI-C scores were compared to the TOVA scores. An inverse correlation was found only between CGI-C and the TOVA-Commission-scores (r = -0.326, p < 0.001). We thus conclude that subjective reports are too unreliable to be used in order to assess MPH benefit in ADHD pediatric populations.

The Impact of Methylphenidate on QbTest Performance of Children with ADHD: A Retrospective Clinical Study

“…14 Several studies, using the Test of Variables of Attention (TOVA ® ), which combines a CPT with minimal language demands and no left-right discrimination, 15 showed improvement in commission scores, response time, and ADHD scores, while significant improvements regarding the omission variable were found in two of three studies. [16][17][18] In preschoolers, the opposite results were obtained with significant improvement in omission, response time score and response time variability score, but not in the commission score, following a single dose of MPH. 19 Studies using advanced CPT versions, including motion analysis, provide additional evidence.…”

Baseline Severity of Parent-Perceived Inattentiveness Is Predictive of the Difference Between Subjective and Objective Methylphenidate Responses in Children with Attention-Deficit/Hyperactivity Disorder

“…In previous studies comparing subjective ADHD symptom rating scales, with scores obtained using an objective neuropsychological test for the assessment of hyperactivity, inattention, and impulsivity, it was found that agreement between these two measurements was not as strong as anticipated (Manor et al 2008;Sumner et al 2010). These results prompted us to find potential predictors associated with differences between subjective perceptions and objective measurements in children with ADHD treated with MPH.…”

A Population-Based Study of Attention Deficit/Hyperactivity Disorder Symptoms and Associated Impairment in Middle-Aged Adults

“…Although the prevalence of ADHD is thought to decrease with age; these estimates suggest that ADHD is one of the most common adult psychiatric disorders. Moreover, the true population prevalence of the disorder is likely to be higher since under-reporting of symptom severity is common and because of problems with current diagnostic methods applied to adults [2], [23], [24].…”