BACKGROUND: This study explored the relationship between personality disorder (PD) and treatment response in a randomized, double-blind, clinical trial of osmotic release oral system (OROS) methylphenidate (MPH). METHODS:Forty-seven patients entered a crossover trial using the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) to assess outcome. A final personality diagnosis was made using staff consensus and information from the Wisconsin Personality Inventory IV (WISPI-IV) and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Three post hoc categories were created: PD-negative (no PD; n = 26), PD-positive (patients with 1 PD; n = 11), and PD-plus (patients with 2 or more PDs; n = 10). Improvement in attention-deficit/hyperactivity disorder (ADHD) symptoms was assessed using a mixed-model analysis with treatment and personality categories as fixed variables. Average z scores on the WISPI-IV and items endorsed on SCID-II provided dimensional measures of PD severity. RESULTS: Different treatment effects were observed for the PD subgroups (P < .001). PD-negative patients improved 40% on OROS MPH vs 7% on placebo, and PD-positive patients improved 66% on OROS MPH vs 9% on placebo. In contrast, PD-plus patients improved 26% on OROS MPH vs 23% on placebo. CONCLUSION: Most patients experienced significantly reduced ADHD symptoms on OROS MPH; however, patients with 2 or more PDs did not. The 2 alternate measures of PD supported this observation in this small exploratory study.
RCT Entities:
BACKGROUND: This study explored the relationship between personality disorder (PD) and treatment response in a randomized, double-blind, clinical trial of osmotic release oral system (OROS) methylphenidate (MPH). METHODS: Forty-seven patients entered a crossover trial using the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) to assess outcome. A final personality diagnosis was made using staff consensus and information from the Wisconsin Personality Inventory IV (WISPI-IV) and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Three post hoc categories were created: PD-negative (no PD; n = 26), PD-positive (patients with 1 PD; n = 11), and PD-plus (patients with 2 or more PDs; n = 10). Improvement in attention-deficit/hyperactivity disorder (ADHD) symptoms was assessed using a mixed-model analysis with treatment and personality categories as fixed variables. Average z scores on the WISPI-IV and items endorsed on SCID-II provided dimensional measures of PD severity. RESULTS: Different treatment effects were observed for the PD subgroups (P < .001). PD-negative patients improved 40% on OROS MPH vs 7% on placebo, and PD-positivepatients improved 66% on OROS MPH vs 9% on placebo. In contrast, PD-pluspatients improved 26% on OROS MPH vs 23% on placebo. CONCLUSION: Most patients experienced significantly reduced ADHD symptoms on OROS MPH; however, patients with 2 or more PDs did not. The 2 alternate measures of PD supported this observation in this small exploratory study.
Authors: B S da Silva; R B Cupertino; D L Rovaris; J B Schuch; D B Kappel; D Müller; C E Bandeira; M M Victor; R G Karam; N R Mota; L A Rohde; V Contini; E H Grevet; C H D Bau Journal: Mol Psychiatry Date: 2017-05-02 Impact factor: 15.992
Authors: Jan Buitelaar; Sven Bölte; Daniel Brandeis; Arthur Caye; Nina Christmann; Samuele Cortese; David Coghill; Stephen V Faraone; Barbara Franke; Markus Gleitz; Corina U Greven; Sandra Kooij; Douglas Teixeira Leffa; Nanda Rommelse; Jeffrey H Newcorn; Guilherme V Polanczyk; Luis Augusto Rohde; Emily Simonoff; Mark Stein; Benedetto Vitiello; Yanki Yazgan; Michael Roesler; Manfred Doepfner; Tobias Banaschewski Journal: Front Behav Neurosci Date: 2022-07-06 Impact factor: 3.617
Authors: Martin A Katzman; Timothy S Bilkey; Pratap R Chokka; Angelo Fallu; Larry J Klassen Journal: BMC Psychiatry Date: 2017-08-22 Impact factor: 3.630