title: Methylphenidate treatment of adult male prison inmates with attention-deficit hyperactivity disorder: randomised double-blind placebo-controlled trial with open-label extension.
abstract: BACKGROUND
  Attention-deficit hyperactivity disorder (ADHD) is highly prevalent in prison inmates, but pharmacological treatment has not yet been evaluated in this group.
  
  
  OBJECTIVE
  To evaluate osmotic-release oral system (OROS) methylphenidate in adult male long-term prison inmates with ADHD.
  
  
  METHODS
  Randomised, double-blind, placebo-controlled 5-week trial, followed by 47-week open-label extension in 30 prison inmates with ADHD and comorbid disorders. Primary outcome was level of ADHD symptoms after 5 weeks, evaluated by a masked assessor. Secondary outcomes were self-reported ADHD symptoms, global severity and global functioning throughout the 52-week trial, and post hoc treatment response and numbers needed to treat (NNT) (trial registration: NCT00482313.)
  
  
  RESULTS
  Treatment significantly improved ADHD during the trial (P<0.001; Cohen's d = 2.17), with reduced symptom severity and improved global functioning. The placebo response, cardiovascular measures and adverse events were non-significant; the NNT was 1.1. Attention-deficit hyperactivity disorder symptoms, global severity and global functioning continued to improve during the open-label extension.
  
  
  CONCLUSIONS
  Osmotic-release oral system methylphenidate is an effective treatment for adult male prison inmates with ADHD.
authors.affiliation: Department of Clinical Neuroscience, Division of Psychiatry and Center of Neurodevelopmental Disorders, Karolinska Institutet, Stockholm, Sweden. ylva.ginsberg@ki.se
authors.forename: Ylva
authors.initials: Y
authors.lastname: Ginsberg
authors.forename: Nils
authors.initials: N
authors.lastname: Lindefors
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D015897:Comorbidity; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D006801:Humans; D057194:Intention to Treat Analysis; D007406:Interview, Psychological; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009995:Osmosis; D010919:Placebos; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000652:urine*; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D010919:Placebos; D008774:Methylphenidate