ADHD 아동에서 나이, 지능, 용량 및 불안 증상에 따른 Oros-methylphenidate 임상효과의 차이

Abstract

Objectives：This study evaluated the differences of Oros-methylphenidate effect of intellectual, cognitive and behavioral aspects in children with combined type of ADHD, according to age, intelligence level, dosage of Orosmethylphenidate and anxiety. Methods：Korean-Wechsler Intelligence Scale for Children-Ⅲ(WISC-Ⅲ) and computerized neurocognitive functions tests(CNT) and ADHD behavioral checklist by Swanson, Nolan and Pelham-Ⅳ(SNAP-Ⅳ) were performed initially and after four weeks of Oros-methylphenidate trial. All of the tests were compared according to age ranges, intelligence levels, dosage levels and degrees of anxiety. Results：The younger age group showed better improvement in commission errors in auditory and visual continuous performance test. The average intelligence group showed the best improvement while the least improvement was in the higher intelligence group. There were no differences of improvement according to dosage levels and there were no consistent findings according to the degree of anxiety either. Conclusions：In the younger age group of ADHD, methylphenidate may improve impulsivity related problems, so methylphenidate may also improve cognitive impulsivity in the younger children with ADHD as well as behavioral impulsivity. The average intelligence group of ADHD showed the best improvement and the lower intelligence group of ADHD also showed significant effect, that is partly because poorer performances in the initial test were improved by methylphenidate. In this study both levels of Oros-methylphenidate dosage were relatively higher than other studies so there were no differences between the lower and the higher dosage group. We should consider various factors such as age, intelligence level, internalizing symptoms when we try methylphenidate and it is recommended that a sufficient dose is better than a lowest effective dose.