Methylphenidate effects on functional outcomes in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS).
OBJECTIVE
The purpose of this study was to examine the effects of methylphenidate (MPH) on functional outcomes, including children's social skills, classroom behavior, emotional status, and parenting stress, during the 4-week, double-blind placebo controlled phase of the Preschoolers with Attention Deficit/Hyperactivity Disorder (ADHD) Treatment Study (PATS).


METHODS
A total of 114 preschoolers who had improved with acute MPH treatment, were randomized to their best MPH dose (M = 14.22 mg/day; n = 63) or placebo (PL; n = 51). Assessments included the Clinical Global Impression-Severity (CGI-S), parent and teacher versions of the Strengths and Weaknesses of ADHD-Symptoms and Normal Behaviors (SWAN), Social Competence Scale (SCS), Social Skills Rating System (SSRS), and Early Childhood Inventory (ECI), and Parenting Stress Index (PSI).


RESULTS
Medication effects varied by informant and outcome measure. Parent measures and teacher SWAN scores did not differentially improve with MPH. Parent-rated depression (p < 0.02) and dysthymia (p < 0.001) on the ECI worsened with MPH, but scores were not in the clinical range. Significant medication effects were found on clinician CGI-S (p < 0.0001) and teacher social competence ratings (SCS, p < 0.03).


CONCLUSIONS
Preschoolers with ADHD treated with MPH for 4 weeks improve in some aspects of functioning. Additional improvements might require longer treatment, higher doses, and/or intensive behavioral treatment in combination with medication.
Abikoff
Howard B
HB
New York University Child Study Center, 215 Lexington Avenue, New York, NY 10016, USA. howard.abikoff@med.nyu.edu
Vitiello
Benedetto
B
Riddle
Mark A
MA
Cunningham
Charles
C
Greenhill
Laurence L
LL
Swanson
James M
JM
Chuang
Shirley Z
SZ
Davies
Mark
M
Kastelic
Elizabeth
E
Wigal
Sharon B
SB
Evans
Lori
L
Ghuman
Jaswinder K
JK
Kollins
Scott H
SH
McCracken
James T
JT
McGough
James J
JJ
Murray
Desiree W
DW
Posner
Kelly
K
Skrobala
Anne M
AM
Wigal
Tim
T
D000339:Affect / Q000187:drug effects; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002652:Child Behavior / Q000187:drug effects; D002675:Child, Preschool; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D004644:Emotions / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D010290:Parents / Q000523:psychology; D012574:Schools; D012919:Social Behavior; D013315:Stress, Psychological / Q000523:psychology; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants; D008774:Methylphenidate