Citation

Sinzig J, Döpfner M, Lehmkuhl G, Uebel H, Schmeck K, Poustka F, Gerber WD, Günter M, Knölker U, Gehrke M, Hässler F, Resch F, Brünger M, Ose C, Fischer R. J. Child Adolesc. Psychopharmacol. 2007; 17(4): 421-432.

Affiliation

Department for Psychiatry and Psychotherapy of Children & Adolescents at the University of Cologne, Köln, Germany. ju.k.sinzig@web.de

Copyright

(Copyright © 2007, Mary Ann Liebert Publishers)

DOI

10.1089/cap.2007.0011

PMID

17822338

Abstract

INTRODUCTION: Aggression is frequently observed in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to assess the efficacy with regard to oppositional and aggressive behavior of a new long-acting methylphenidate preparation (Medikinet retard, MPH-MR), with equal portions of the immediate-release and the sustained-release active substance, and especially to look at correlations between either teacher or parent assessment of aggression and ADHD sub-symptomatology. METHODS: Eighty five children and adolescents (6-16 years) were investigated in a double-blind, randomized, clinical trial over 5 weeks under a treatment with MPH-MR using symptom checklists for ADHD, oppositional-defiant and conduct disorder according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). RESULTS: A total of 64.9% of the children showed oppositional defiant disorder/conduct disorder (ODD/CD) symptoms. A statistically significant effect was found in the group treated with MPH (verum-group). On the basis of Cohen's criteria, high effects were found for aggressive symptoms in school (d = 1.0), but not in the afternoon (d = 0.4). There were also lower effect sizes for more severe aggressive symptoms. We found characteristic correlations between ODD/CD symptoms and the ADHD subscale hyperactivity/impulsivity compared to the subscale inattention. CONCLUSIONS: Long-acting MPH is effective in the treatment of oppositional-defiant and aggressive behavior, especially concerning milder symptoms. The expected correlation between impulsivity and aggressiveness could be confirmed.

Language: en