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. 2022 Dec;272(8):1437-1442.
doi: 10.1007/s00406-022-01386-9. Epub 2022 Feb 24.

Clinical characteristics of children and adolescents with ADHD with or without methylphenidate prescription at their first diagnostic assessment

Pietro De Rossi  1 , Italo Pretelli  1 , Deny Menghini  1 , Barbara D'Aiello  1   2 , Silvia Di Vara  1 , Stefano Vicari  3   4   5
Affiliations

Clinical characteristics of children and adolescents with ADHD with or without methylphenidate prescription at their first diagnostic assessment

Pietro De Rossi et al. Eur Arch Psychiatry Clin Neurosci. 2022 Dec.

Abstract

Attention Deficit/Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder diagnosed in the scholar age. It is associated with significant impairment in global functioning, and in moderate/severe presentations the outcome is critically dependent on pharmacological optimization of the multi-modal treatment. Methylphenidate (MPH) is the first-choice pharmacological treatment in children and adolescents with ADHD, with substantial evidence of significant efficacy and effectiveness on global functioning and symptoms' severity. There is some evidence supporting a few clinical and socio-demographic variables as predictors of pharmacological treatment prescription in children with ADHD independently of ADHD symptoms severity. However, it is warranted to investigate clinical and general psychopathological characteristics potentially associated with negative outcomes and the need for pharmacological treatment to inform appropriate prescription strategies. In this context, we compared 268 children and adolescents who were prescribed MPH (ADHD/MPH) for the first time after their first diagnostic assessment at our center, and 444 children and adolescents with ADHD (ADHD/noMPH) who were recommended non-pharmacological evidence-based interventions alone. ADHD/MPH group had higher severity of non-ADHD psychopathological symptoms compared to the ADHD/noMPH group, as documented by higher scores on the Child Behavior Checklist (CBCL) subscales, higher severity of ADHD symptoms, lower average IQ and lower adaptive levels independently of IQ. More specifically, beside externalizing symptoms, also internalizing symptoms were significantly higher in the ADHD/MPH group. The presence of significant non-ADHD psychopathology should be considered as a clinical factor associated with the need for MPH prescription in children and adolescents with ADHD.

Keywords: ADHD; Early intervention; Methylphenidate; Psychopathology; Treatment predictors.

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References

    1. Polanczyk G, de Lima MS, Horta BL et al (2007) The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 164:942–948 - DOI - PubMed
    1. Polanczyk GV, Willcutt EG, Salum GA et al (2014) ADHD prevalence estimates across three decades: An updated systematic review and meta-regression analysis. Int J Epidemiol 43:434–442 - DOI - PubMed - PMC
    1. Donfrancesco R, Marano A, Calderoni D et al (2015) Prevalence of severe ADHD: an epidemiological study in the Italian regions of Tuscany and Latium. Epidemiol Psychiatr Sci 24:525–533 - DOI - PubMed
    1. Arnold LE, Hodgkins P, Caci H et al (2015) Effect of treatment modality on long-term outcomes in attention-deficit/hyperactivity disorder: A systematic review. PLoS ONE 10(2):e0116407 - DOI - PubMed - PMC
    1. Cortese S, Adamo N, Del Giovane C et al (2018) Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry 5(9):727–738 - DOI - PubMed - PMC

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