Abstract:
OBJECTIVE:To evaluate the efficacy and safety of dexmethylphenidate hydrochloride (d-MPH, Focalin) for the treatment of attention-deficit/hyperactivity disorder (ADHD) and to test an a priori hypothesis that d-MPH would have a longer duration of action than d,l-threo-methylphenidate (d,l-MPH). METHOD:This was a randomized, double-blind study conducted at 12 U.S. centers. One hundred thirty-two subjects received d-MPH (n=44), d,l-MPH (n=46), or placebo (n=42) twice daily for 4 weeks, with titration of the dose based on weekly clinic visits. The primary efficacy variable was change from baseline to last study visit on teacher-completed Swanson, Nolan, and Pelham Rating Scale (Teacher SNAP). Secondary efficacy measures included the change on parent-completed SNAP (Parent SNAP), Clinical Global Impressions Scale-Improvement (CGI-I) score, and Math Test performance. Assessments at home in late afternoon were included to test the hypothesis that d-MPH would have a longer duration of efficacy than d,l-MPH. Safety was assessed through monitoring occurrence and severity of adverse events and discontinuations related to them. RESULTS:Treatment with either d-MPH (p=.0004) or d,l-MPH (p=.0042) significantly improved Teacher SNAP ratings compared with placebo. The d-MPH group showed significant improvements compared with placebo on the afternoon Parent SNAP ratings (p=.0003) and scores on the Math Test (p=.0236) obtained late in the afternoon at 6:00 p.m. Sixty-seven percent of patients showed improvement on d-MPH and 49% on d,l-MPH based on CGI-I scores. Both d-MPH and d,l-MPH were well tolerated, no patient in the d-MPH group and only two patients each in the d,l-MPH and placebo groups discontinued the study. CONCLUSIONS:For the treatment of ADHD, an average titrated dose of 18.25 mg/day of d-MPH is as efficacious and safe as an average titrated dose of 32.14 mg/day of d,l-MPH. Both active treatments have large effect sizes. Thus, d-MPH and d,l-MPH appear to provide similar efficacy, and d-MPH may have longer duration of action after twice-daily dosing, but additional studies are needed to determine the statistical and clinical significance of this possibility.
journal_name
J Am Acad Child Adolesc Psychiatryauthors
Wigal S,Swanson JM,Feifel D,Sangal RB,Elia J,Casat CD,Zeldis JB,Conners CKdoi
10.1097/01.chi.0000138351.98604.92subject
Has Abstractpub_date
2004-11-01 00:00:00pages
1406-14issue
11eissn
0890-8567issn
1527-5418pii
S0890-8567(09)61610-5journal_volume
43pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract::The relationship between adolescent bipolar illness and personality disorder has not been explored. Studies of adult bipolars suggest a bipolar illness/borderline personality disorder (BPD) association. Twenty euthymic bipolar teens were assessed using the Personality Disorders Examination. Thirty-five percent met DSM...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199005000-00004
更新日期:1990-05-01 00:00:00
abstract::Internal consistency of the major diagnostic categories for children was assessed, using the symptom scale scores of the Child Assessment Schedule. Alpha coefficients were calculated for three samples: 116 nonpsychotic psychiatrically disturbed children, 63 children with cystic fibrosis, and 177 children from a commun...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199007000-00019
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVE:As part of the Journal's 10-year Research Update Reviews, a series of articles will be presented on the role of rating scales in child and adolescent psychiatry. The first article in the series summarizes principles underlying scale functioning. METHOD:Sources were reviewed regarding testing theory, scale de...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,评审
doi:10.1097/00004583-200202000-00004
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between components of death concept (preoccupation with death, death as a pleasant state, and death as final) and suicidal behavior in adolescents. METHOD:The death concepts of 51 suicidal inpatients, 102 nonsuicidal inpatients, 36 emergency room suicidal subjects, and 81 norm...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199812000-00011
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:To examine the treatment implications of a reported history of maltreatment in a sample of 343 children referred to Los Angeles area mental health clinics for emotional and behavioral problems. METHOD:Child Protective Service records identified 161 of the 343 families as having a documented history of maltre...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/01.CHI.0000085754.71002.14
更新日期:2003-11-01 00:00:00
abstract::In a recent review of nonbehavioral child and adolescent psychotherapy, it was concluded that the magnitude of methodological flaws in this body of research precluded an evaluation of effectiveness. However, recent quantitative reviews of child and adolescent therapy have concluded that nonbehavioral therapy is relati...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,meta分析
doi:10.1097/00004583-199207000-00019
更新日期:1992-07-01 00:00:00
abstract::How should treatment be initiated for children with obsessive-compulsive disorder (OCD)? This editorial comments on an article by Melin and colleagues,1 published in this issue, from the NordLOTS study, which reports excellent outcomes from cognitive behavior therapy (CBT) for children with OCD. Children continued to ...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 评论,社论
doi:10.1016/j.jaac.2019.03.015
更新日期:2020-02-01 00:00:00
abstract::A system proposed by Wing and coworkers for subtyping autistic individuals on the basis of social interaction is examined in 78 autistic, 39 atypical, and 32 nonautistic, developmentally disordered individuals. Clinical ratings and questionnaire data based on the proposed subtypology were employed. Clinicians were abl...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-198901000-00015
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To compare the pattern of familial aggregation of psychopathology in children who are good responders (GR) to methylphenidate (MPH) versus those who are poor responders (PR). METHOD:A total of 118 clinically referred children ages 6 to 12 years, diagnosed with ADHD participated in a double-blind, placebo-con...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.chi.0000184932.64294.d9
更新日期:2006-01-01 00:00:00
abstract::For several decades, national surveys and reports have well documented the serious, growing, and unmet need for mental and behavioral health services among children, adolescents, and young adults (C/A/YA) in the United States.1-3 Moreover, shortages and maldistribution of child and adolescent psychiatrists have been r...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 社论
doi:10.1016/j.jaac.2019.09.028
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:Suicidal behavior and self-harm are common in adolescents and are associated with elevated psychopathology, risk of suicide, and demand for clinical services. Despite recent advances in the understanding and treatment of self-harm and links between self-harm and suicide and risk of suicide attempt, progress i...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jaac.2014.10.009
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:A twin study design was used to examine the genetic validity of attention-deficit hyperactivity disorder (ADHD)-related phenotypes. METHOD:Questionnaires covering ADHD symptoms were sent to the families of 2,846 school-age twins. Parent-rated symptoms were obtained for 2,082 twin pairs and teacher-rated symp...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-200012000-00015
更新日期:2000-12-01 00:00:00
abstract::One of the most discussed recent topics in psychopathology research is the p factor of mental illness. This single dimension is understood to measure "a person's liability to mental disorder, comorbidity among disorders, persistence of disorders over time, and severity of symptoms."1 A recent paper by Constantinou et ...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 评论,信件
doi:10.1016/j.jaac.2019.07.953
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:The two primary-seemingly contradictory-strategies for classifying child psychiatric syndromes are categorical and dimensional; conceptual ambiguities appear to be greatest for polythetic syndromes such as autism spectrum disorder (ASD). Recently, a compelling alternative has emerged that integrates both cate...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2018.09.431
更新日期:2019-09-01 00:00:00
abstract::Both longitudinal and cross-sectional studies utilizing population and family study samples have found evidence for a secular increase in major affective disorders in adults. Applying techniques used in cross-sectional studies in adults to family study data of children and adolescents, the authors demonstrate evidence...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199207000-00004
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVE:To assess the course and outcome of anorexia nervosa (AN) and bulimia nervosa (BN) at a median of 90 months of follow-up in a large cohort of women with eating disorders. METHOD:A prospective, naturalistic, longitudinal design was used to map the course of AN and BN in 246 women. Follow-up data are presented...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199907000-00012
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:To give academic researchers, government officials, and industry scientists an opportunity to assess the state of pediatric psychopharmacology and identify challenges facing professionals in the field. METHOD:Increased federal spending and the introduction of pediatric exclusivity led to large increases in p...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/01.chi.0000194568.70912.ee
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To examine the relationship between cognitive variables and time until suicide attempts among 180 adolescents who were monitored for as much as 6.9 years after discharge from an inpatient psychiatry unit. METHOD:In a prospective naturalistic study, adolescents were assessed at the time of their psychiatric h...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-200101000-00021
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:An alternative set of criteria for posttraumatic stress disorder (PTSD) for preschool children was analyzed for validity. METHOD:Sixty-two traumatized children and 63 healthy controls, aged 20 months through 6 years, were assessed. The traumatic experiences included motor vehicle collisions, accidental injur...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/01.CHI.0000046822.95464.14
更新日期:2003-05-01 00:00:00
abstract::The association of elective mutism and mental retardation is noted. Two cases of elective mutism associated with mental retardation are presented. Both individuals had long-standing patterns of inhibition, shyness, and anxiety manifested by general refusal to talk outside the home, particularly at school. The importan...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199307000-00023
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVE:Childhood conduct problems are associated with poor functioning in early adulthood. We tested a series of hypotheses to understand the mechanisms underlying this association. METHOD:We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a birth cohort of 2,232 twins born in England and Wa...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2017.09.437
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:A pilot study to evaluate the efficacy of a cognitive-behavioral group therapy program for adolescents with social phobia, simplified both in terms of time and labor intensity from a previously studied program (Social Effectiveness Therapy for Children and Adolescents) to be more appropriate for a community o...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004583-200503000-00010
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To determine whether an algorithm for the treatment of attention-deficit/hyperactivity disorder (ADHD) can be implemented in a community mental health center. METHOD:Fifty child and adolescent patients at Texas community mental health centers who met criteria for ADHD were treated according to an algorithm-b...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-200303000-00007
更新日期:2003-03-01 00:00:00
abstract::Mania occurs sometimes in association with an organic condition affecting the brain. A case of a 15-year-old girl with secondary mania related to multiple sclerosis is described, along with a selective review of the subject. The English-language literature published from 1986 to 1994 was reviewed, but geriatric and me...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,评审
doi:10.1097/00004583-199512000-00009
更新日期:1995-12-01 00:00:00
abstract::The clinical guidance based on the research article, "Specific Components of Pediatricians' Medication-Related Care Predict Attention-Deficit/Hyperactivity Disorder Improvement," published in the June 2017 issue,1 might be premature. The authors, Epstein et al., suggest that "Physicians do not need to necessarily rely...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 信件
doi:10.1016/j.jaac.2018.02.015
更新日期:2018-06-01 00:00:00
abstract::Interpersonal psychotherapy (IPT) is a brief treatment developed and tested specifically for depressed adults. This paper describes a modification for use with depressed adolescents (IPT-A) that will be tested in a controlled clinical trial. A description of IPT, its efficacy in adults, a rationale for developing IPT-...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199107000-00018
更新日期:1991-07-01 00:00:00
abstract:OBJECTIVE:Although a small literature of case reports suggests that mania co-occurs with pervasive developmental disorder (PDD), little is known about this overlap. The authors systematically investigated the overlap between mania and PDD in a consecutive sample of referred youths, examining its prevalence and correlat...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/S0890-8567(09)66564-3
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:To examine patterns of variability in social visual engagement and their relationship to standardized measures of social disability in a heterogeneous sample of school-aged children with autism spectrum disorders (ASD). METHOD:Eye-tracking measures of visual fixation during free-viewing of dynamic social sce...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2011.12.017
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:The DSM-IV-TR criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve dia...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2012.03.010
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To evaluate cognitive-behavioral therapy, antidepressant medication alone, and combined CBT and antidepressant medication in the treatment of depressive disorders in adolescents. METHOD:Seventy-three adolescents (ages 12-18 years) with a primary diagnosis of DSM-IV major depressive disorder, dysthymic disord...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.chi.0000233157.21925.71
更新日期:2006-10-01 00:00:00