Comorbidity moderates response to methylphenidate in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS)

Jaswinder K. Ghuman, Mark A Riddle, Benedetto Vitiello, Laurence L. Greenhill, Shirley Z. Chuang, Sharon B. Wigal, Scott H. Kollins, Howard B. Abikoff, James T. McCracken, Elizabeth A Kastelic, Alexander M. Scharko, James J. McGough, Desiree W. Murray, Lori Evans, James M. Swanson, Tim Wigal, Kelly Posner, Charles Cunningham, Mark Davies, Anne M. Skrobala

Research output: Contribution to journalArticle

Abstract

Objective: The aim of this study was to examine whether demographic or pretreatment clinical and social characteristics influenced the response to methylphenidate (MPH) in the Preschoolers with ADHD Treatment Study (PATS). Methods: Exploratory moderator analyses were conducted on the efficacy data from the PATS 5-week, double-blind, placebo-controlled six-site titration trial. Children (N = 165, age 3-5.5 years) were randomized to 1 week each of four MPH doses (1.25, 2.5, 5, and 7.5 mg) and placebo administered three times per day (t.i.d.). We assessed the fixed effects on the average slope in the regression outcome on moderators, weight-adjusted dose, and the moderator-by-dose interaction using SAS PROC GENMOD. Results: A significant interaction effect was found for a number of co-morbid disorders diagnosed in the preschoolers at baseline (p = 0.005). Preschoolers with three or more co-morbid disorders did not respond to MPH (Cohen's d at 7.5 mg dose relative to placebo = -0.37) compared to a significant response in the preschoolers with 0, 1, or 2 co-morbid disorders (Cohen's d = 0.89, 1.00, and 0.56, respectively). Preschoolers with more co-morbidity were found to have more family adversity. No significant interaction effect was found with the other variables. Conclusions: In preschoolers with ADHD, the presence of no or one co-morbid disorder (primarily oppositional defiant disorder) predicted a large treatment response at the same level as has been found in school-aged children, and two co-morbid disorders predicted moderate treatment response; whereas the presence of three or more co-morbid disorders predicted no treatment response to MPH.

Original languageEnglish (US)
Pages (from-to)563-579
Number of pages17
JournalJournal of Child and Adolescent Psychopharmacology
Volume17
Issue number5
DOIs
StatePublished - Nov 1 2007

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Methylphenidate
Attention Deficit Disorder with Hyperactivity
Comorbidity
Placebos
Attention Deficit and Disruptive Behavior Disorders
Therapeutics
Demography
Morbidity
Weights and Measures

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Psychiatry and Mental health
  • Pediatrics, Perinatology, and Child Health
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Comorbidity moderates response to methylphenidate in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS). / Ghuman, Jaswinder K.; Riddle, Mark A; Vitiello, Benedetto; Greenhill, Laurence L.; Chuang, Shirley Z.; Wigal, Sharon B.; Kollins, Scott H.; Abikoff, Howard B.; McCracken, James T.; Kastelic, Elizabeth A; Scharko, Alexander M.; McGough, James J.; Murray, Desiree W.; Evans, Lori; Swanson, James M.; Wigal, Tim; Posner, Kelly; Cunningham, Charles; Davies, Mark; Skrobala, Anne M.

In: Journal of Child and Adolescent Psychopharmacology, Vol. 17, No. 5, 01.11.2007, p. 563-579.

Research output: Contribution to journalArticle

Ghuman, JK, Riddle, MA, Vitiello, B, Greenhill, LL, Chuang, SZ, Wigal, SB, Kollins, SH, Abikoff, HB, McCracken, JT, Kastelic, EA, Scharko, AM, McGough, JJ, Murray, DW, Evans, L, Swanson, JM, Wigal, T, Posner, K, Cunningham, C, Davies, M & Skrobala, AM 2007, 'Comorbidity moderates response to methylphenidate in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS)', Journal of Child and Adolescent Psychopharmacology, vol. 17, no. 5, pp. 563-579. https://doi.org/10.1089/cap.2007.0071
Ghuman, Jaswinder K. ; Riddle, Mark A ; Vitiello, Benedetto ; Greenhill, Laurence L. ; Chuang, Shirley Z. ; Wigal, Sharon B. ; Kollins, Scott H. ; Abikoff, Howard B. ; McCracken, James T. ; Kastelic, Elizabeth A ; Scharko, Alexander M. ; McGough, James J. ; Murray, Desiree W. ; Evans, Lori ; Swanson, James M. ; Wigal, Tim ; Posner, Kelly ; Cunningham, Charles ; Davies, Mark ; Skrobala, Anne M. / Comorbidity moderates response to methylphenidate in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS). In: Journal of Child and Adolescent Psychopharmacology. 2007 ; Vol. 17, No. 5. pp. 563-579.
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title = "Comorbidity moderates response to methylphenidate in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS)",
abstract = "Objective: The aim of this study was to examine whether demographic or pretreatment clinical and social characteristics influenced the response to methylphenidate (MPH) in the Preschoolers with ADHD Treatment Study (PATS). Methods: Exploratory moderator analyses were conducted on the efficacy data from the PATS 5-week, double-blind, placebo-controlled six-site titration trial. Children (N = 165, age 3-5.5 years) were randomized to 1 week each of four MPH doses (1.25, 2.5, 5, and 7.5 mg) and placebo administered three times per day (t.i.d.). We assessed the fixed effects on the average slope in the regression outcome on moderators, weight-adjusted dose, and the moderator-by-dose interaction using SAS PROC GENMOD. Results: A significant interaction effect was found for a number of co-morbid disorders diagnosed in the preschoolers at baseline (p = 0.005). Preschoolers with three or more co-morbid disorders did not respond to MPH (Cohen's d at 7.5 mg dose relative to placebo = -0.37) compared to a significant response in the preschoolers with 0, 1, or 2 co-morbid disorders (Cohen's d = 0.89, 1.00, and 0.56, respectively). Preschoolers with more co-morbidity were found to have more family adversity. No significant interaction effect was found with the other variables. Conclusions: In preschoolers with ADHD, the presence of no or one co-morbid disorder (primarily oppositional defiant disorder) predicted a large treatment response at the same level as has been found in school-aged children, and two co-morbid disorders predicted moderate treatment response; whereas the presence of three or more co-morbid disorders predicted no treatment response to MPH.",
author = "Ghuman, {Jaswinder K.} and Riddle, {Mark A} and Benedetto Vitiello and Greenhill, {Laurence L.} and Chuang, {Shirley Z.} and Wigal, {Sharon B.} and Kollins, {Scott H.} and Abikoff, {Howard B.} and McCracken, {James T.} and Kastelic, {Elizabeth A} and Scharko, {Alexander M.} and McGough, {James J.} and Murray, {Desiree W.} and Lori Evans and Swanson, {James M.} and Tim Wigal and Kelly Posner and Charles Cunningham and Mark Davies and Skrobala, {Anne M.}",
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T1 - Comorbidity moderates response to methylphenidate in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS)

AU - Ghuman, Jaswinder K.

AU - Riddle, Mark A

AU - Vitiello, Benedetto

AU - Greenhill, Laurence L.

AU - Chuang, Shirley Z.

AU - Wigal, Sharon B.

AU - Kollins, Scott H.

AU - Abikoff, Howard B.

AU - McCracken, James T.

AU - Kastelic, Elizabeth A

AU - Scharko, Alexander M.

AU - McGough, James J.

AU - Murray, Desiree W.

AU - Evans, Lori

AU - Swanson, James M.

AU - Wigal, Tim

AU - Posner, Kelly

AU - Cunningham, Charles

AU - Davies, Mark

AU - Skrobala, Anne M.

PY - 2007/11/1

Y1 - 2007/11/1

N2 - Objective: The aim of this study was to examine whether demographic or pretreatment clinical and social characteristics influenced the response to methylphenidate (MPH) in the Preschoolers with ADHD Treatment Study (PATS). Methods: Exploratory moderator analyses were conducted on the efficacy data from the PATS 5-week, double-blind, placebo-controlled six-site titration trial. Children (N = 165, age 3-5.5 years) were randomized to 1 week each of four MPH doses (1.25, 2.5, 5, and 7.5 mg) and placebo administered three times per day (t.i.d.). We assessed the fixed effects on the average slope in the regression outcome on moderators, weight-adjusted dose, and the moderator-by-dose interaction using SAS PROC GENMOD. Results: A significant interaction effect was found for a number of co-morbid disorders diagnosed in the preschoolers at baseline (p = 0.005). Preschoolers with three or more co-morbid disorders did not respond to MPH (Cohen's d at 7.5 mg dose relative to placebo = -0.37) compared to a significant response in the preschoolers with 0, 1, or 2 co-morbid disorders (Cohen's d = 0.89, 1.00, and 0.56, respectively). Preschoolers with more co-morbidity were found to have more family adversity. No significant interaction effect was found with the other variables. Conclusions: In preschoolers with ADHD, the presence of no or one co-morbid disorder (primarily oppositional defiant disorder) predicted a large treatment response at the same level as has been found in school-aged children, and two co-morbid disorders predicted moderate treatment response; whereas the presence of three or more co-morbid disorders predicted no treatment response to MPH.

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