The Studies Of Clinical Features And OROS-MPH Effects Of Subtypes Of Attention Deficit Hyperactivity Disorder On Children

Objective:1.To analyze the features of various subtypes of attention deficit hyperactivity disorder(ADHD) in children;2.To study the effects of methylphenidate extended-release tablets (OROS-MPH) on various Subtypes of ADHD;3.To evaluate the effects of EEG biofeedback on ADHD.Methods:1.Clinical features of Subtypes of ADHD in Children:Sex composition,age of onset, risk factors,comorbidities,intelligence quotient and behavioral problems were analyzed in 175 children with ADHD(82 ADHD-I,24 ADHD-HI and 69 ADHD-C) who met the 4th edition of Diagnostic Statistical Manual of Mental disorder criteria(DSM-Ⅳ).2.Effects of OROS-MPH on various Subtypes of ADHD:92 children with ADHD(35 ADHD-I,19 ADHD-HI and 38 ADHD-C) who met the DSM-Ⅳdiagnostic criteria were given OROS-MPH for 6 weeks.The efficacy of OROS-MPH was evaluated according to IOWA Conners Parents Rating Scale and Conners Parents Rating Scale every two weeks.3.Effects of EEG Biofeedback on Children with ADHD:60 children with ADHD who met the DSM-Ⅳdiagnostic criteria were randomly assigned to Electroencephalogram(EEG) biofeedback group(30 cases) and OROS-MPH group (30 cases).Effects of EEG biofeedback and OROS-MPH were compared before and after the interventions according to IOWA Conners rating scale and integrated visual and auditory continuous performance test(IVA-CPT).All the patients were followed-up for two months after the interventions.Results:1.Clinical features of Subtypes of ADHD in Children:There were no significantly differences on sex composition among the three subtypes(P＞0.05);Both the age of onset and age at diagnosis in the group with ADHD-HI were the youngest,then the group with ADHD-C and the group with ADHD-I in turn;The rates of birth abnormality in the ADHD-I and the ADHD-C were higher than those in the ADHD-HI,the rates of improper parent's education in the ADHD-HI and the ADHD-C were higher than those in the ADHD-I;There were no significant differences for performance intelligence quotient(PIQ),verbal intelligence quotient(VIQ) and full intelligence quotient(FIQ) among the three subtype(P＞0.05).However,the incidences of imbalance between VIQ and PIQ in ADHD-I were the highest.For the ADHD-C and the ADHD-HI,the incidences of comorbidities with oppositional defiant disorder(ODD) and tic disorder(TD) were higher than those in the ADHD-I.Both the ADHD-I and the ADHD-C had higher incidence of comorbidity with learning disorder(LD) compared to the ADHD-HI; Implusive/hyperactive,conduct problem and hyperactivity index in the ADHD-C and the ADHD-HI were more than those in the ADHD-I based on Conners Parent Rating Scales,but the learning problems of ADHD-I were the worst among the three subtypes.2.Effects of OROS-MPH on various Subtypes of ADHD:The scores of I/O,O/D and the total of IOWA Conners Rating Scale after the OROS-MPH therapy were lower than those before the therapy in the three groups(P＜0.05).The difference values of the scores of IOWA Conners Rating Scale between before and after the interventions in the ADHD-C group and the ADHD-HI group were higher than those in the ADHD-I group,but no significant differences between the ADHD-HI group and the ADHD-C group.The scores of Conners Rating Scale reduced significantly after the therapy in the three groups(P＜0.05).The difference values of the scores between before and after the interventions in the ADHD-C group and the ADHD-HI group were higher than those in the ADHD-I group on conduct problem,actuation/hyperactivity and hyperactivity index,but no significantly difference between the ADHD-HI group and the ADHD-C group.The difference values of the scores on learning problem between before and after interventions in the ADHD-I group were higher than those in the ADHD-C group and the ADHD-HI group.3.Effects of EEG Biofeedback on Children with ADHD:There were significant differences before and after the EEG biofeedback training or OROS-MPH therapy for the scores of IOWA Conners Rating Scale and the indexes of IVA-CPT such as the full scale response control quotient and the full scale attention quotient(P＜0.05).But the indexes and the scores in the OROS-MPH group improved better than those in the EEG biofeedback group(P＜0.05).The scores of IOWA Conners Rating Scale rebounded when the OROS-MPH was discontinued in OROS-MPH group,however,EEG biofeedback group showed a persistent improvement.Conclusion:1.There are significant differences on comorbidities,intelligence quotient and behavioral problems among the three subtypes of ADHD.The incidences of comorbidities with ODD,TD and disruptive behavior problems in the ADHD-C group and the ADHD-HI group were higher than the ADHD-I group.But there are higher incidences of learning problems and imbalance between VIQ and PIQ in the ADHD-I group.It is suggested that different pathogenesises may play a role in various subtypes of ADHD.2.OROS-MPH is effective and safe for children with ADHD.There are significant differences of OROS-MPH's efficacies among subtypes of ADHD in children.Generally,OROS-MPH shows better effects on both the ADHD-C group and the ADHD-HI group than those on the ADHD-I group.There are significant improvements on disruptive behavior problems both in the ADHD-C group and the ADHD-HI group,and on learning problems in the ADHD-I group.3.EEG biofeedback training is an effective treatment for children with ADHD.But the short term effects of EEG biofeedback is inferior to OROS-MPH.EEG biofeedback training shows slower but more stable and permanent effects compared to OROS-MPH.