Factors Related to Methylphenidate Response in Children With Attention Deficit/Hyperactivity Disorder: A Retrospective Study

Abstract

Objective: We aimed to explore the predictive value of clinical features and self-concept on methylphenidate (MPH) response in children with attention deficit/hyperactivity disorder (ADHD). Methods: The study had a naturalistic design where the results were analyzed retrospectively. ADHD and comorbidity were diagnosed by Schedule for Affective Disorders and Schizophrenia for School-Age Children Present Lifetime Version (K-SADS-PL). At the baseline assessment, parents completed Turgay DSM-IV Disruptive Disorders Rating Scale (T-DSM-IV-S) and Child Behavior Check List (CBCL); teachers were given T-DSM-IV-S, CBCL. The children completed Piers-Harris Children's Self-Concept Scale (PHSCS), Children's Depression Inventory (CDI), and Screen for Child Anxiety Related Emotional Disorders (SCARED). Following 4-8 weeks of MPH treatment, the parents completed T-DSM-IV-S and the clinician completed Clinical Global Impression-Improvement scale (CGI-I). This study included 54 children (18 girls, 36 boys; mean age 9.32±0.21 years old). The sample was divided in "good responders" (GR) and "poor responders" (PR) regarding the response criteria defined by authors. Results: The PR group had significantly higher rates of anxiety disorders, higher internalizing scores and lower PHSCS scores compared to GR. Comorbid anxiety disorders, elimination disorders and negative selfconcept were found to predict poor MPH response by multiple regression analysis. Conclusions: The results point to the need for additional interventions in the presence of comorbid anxiety, incontinence or poor self-concept in children with ADHD.