PubMed · 15516555
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K A L A Kuruppuarachchi, L T Wijeratne. 2004. ADHD in developing countries.. https://doi.org/10.1192/bjp.185.5.439
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Children with attention-deficit/hyperactivity disorder (ADHD) often encounter problems in social interactions with peers and are confronted with peer rejection and social isolation. The most common approach to social problems in children is social skills training. This intervention concept represents a variable mixture of cognitive-behavioral intervention elements. In this article the outcome of social skills training (SST) for children with ADHD is reviewed. Four experimental SSTs are detected and analyzed for potential mediators and moderators of treatment efficacy. Candidate mediators (social cognitive skills, parenting style and medication-induced reduction of key symptoms) are discussed within an empirical and theoretical context. Candidate moderators (subtype, comorbidity, gender and age) are evaluated for their empirical support. It is argued that, although fragmented, there is ample evidence and knowledge to adapt the SST-paradigm towards the specific needs of children suffering from ADHD and to guide future research towards more effective, "well established" interventions.
OBJECTIVE: To compare the efficacy and safety of two methylphenidate (MPH) formulations--once-daily modified-release MPH (EqXL, Equasym XL) and twice-daily immediate-release methylphenidate (MPH-IR, Ritalin)--and placebo in children with Attention Deficit/Hyperactivity Disorder (ADHD). METHODS: Children aged 6-12 years on a stable dose of MPH were randomized into a double-blind, three-arm, parallel-group, multi-center study and received 3 weeks of EqXL (20, 40, or 60 mg qd), MPH-IR (10, 20, or 30 mg bid) or placebo. Non-inferiority of EqXL to MPH-IR was assessed by the difference in the inattention/overactivity component of the overall teacher's IOWA Conners' Rating Scale on the last week of treatment (per protocol population). Safety was monitored by adverse events, laboratory parameters, vital signs, physical exam, and a Side Effect Rating Scale. RESULTS: The lower 97.5% confidence interval bound of the difference between MPH groups fell above the non-inferiority margin (-1.5 points) not only during the last week of treatment but during all three treatment weeks. Both MPH-treatment groups experienced superior benefit when compared to placebo during all treatment weeks (P < 0.001). All treatments were well tolerated. CONCLUSIONS: EqXL given once-daily was non-inferior to MPH-IR given twice-daily. Both treatments were superior to placebo in reducing ADHD symptoms.