Clinical response to methylphenidate in children diagnosed with attention-deficit hyperactivity disorder and comorbid psychiatric disorders.
OBJECTIVE
To determine to what extent the clinical response to methylphenidate (MPH) is affected by psychiatric comorbidities in children diagnosed with attention-deficit hyperactivity disorder (ADHD).


METHODS
Children (n = 267) aged 6 to 12 years diagnosed with ADHD participated in a double-blind, placebo-controlled, 2-week medication trial of MPH. Children were assessed using parent and teacher ratings and laboratory measures. Clinical response to MPH was determined by integrating all obtained measures.


RESULTS
Meeting criteria for conduct disorder (CD) was 27.7% of children, 40.8% for oppositional defiant (ODD), 47.2% for anxiety, and 7.9% for depressive disorders. The presence of CD or ODD was associated with good response to MPH. In contrast, children diagnosed with only comorbid anxiety were more likely to receive poor response rating independent of age, sex, or socioeconomic status. Low family income was found to be predictive of good response to MPH.


CONCLUSIONS
The response to MPH in children with ADHD may be dependent on the type of comorbid disorder present.


BACKGROUND
NCT00483106.
Ter-Stepanian
Mariam
M
Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec.
Grizenko
Natalie
N
Zappitelli
Michael
M
Joober
Ridha
R
D001008:Anxiety Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D019955:Conduct Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D018592:Cross-Over Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D010552:Personality Assessment; D012959:Socioeconomic Factors; D016896:Treatment Outcome
D008774:Methylphenidate