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Clinical characteristics of children and adolescents with ADHD with or without methylphenidate prescription at their first diagnostic assessment

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European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Attention Deficit/Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder diagnosed in the scholar age. It is associated with significant impairment in global functioning, and in moderate/severe presentations the outcome is critically dependent on pharmacological optimization of the multi-modal treatment. Methylphenidate (MPH) is the first-choice pharmacological treatment in children and adolescents with ADHD, with substantial evidence of significant efficacy and effectiveness on global functioning and symptoms’ severity. There is some evidence supporting a few clinical and socio-demographic variables as predictors of pharmacological treatment prescription in children with ADHD independently of ADHD symptoms severity. However, it is warranted to investigate clinical and general psychopathological characteristics potentially associated with negative outcomes and the need for pharmacological treatment to inform appropriate prescription strategies. In this context, we compared 268 children and adolescents who were prescribed MPH (ADHD/MPH) for the first time after their first diagnostic assessment at our center, and 444 children and adolescents with ADHD (ADHD/noMPH) who were recommended non-pharmacological evidence-based interventions alone. ADHD/MPH group had higher severity of non-ADHD psychopathological symptoms compared to the ADHD/noMPH group, as documented by higher scores on the Child Behavior Checklist (CBCL) subscales, higher severity of ADHD symptoms, lower average IQ and lower adaptive levels independently of IQ. More specifically, beside externalizing symptoms, also internalizing symptoms were significantly higher in the ADHD/MPH group. The presence of significant non-ADHD psychopathology should be considered as a clinical factor associated with the need for MPH prescription in children and adolescents with ADHD.

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Authors and Affiliations

  1. Department of Neuroscience, Child and Adolescence Neuropsychiatry Unit, I. R. C. C. S. Bambino Gesù Children’s Hospital, Rome, Italy

    Pietro De Rossi, Italo Pretelli, Deny Menghini, Barbara D’Aiello, Silvia Di Vara & Stefano Vicari

  2. Department of Human Science, LUMSA University, Rome, Italy

    Barbara D’Aiello

  3. Department of Life Sciences and Public Health, Catholic University, Rome, Italy

    Stefano Vicari

  4. Centro di Riabilitazione, Casa San Giuseppe, Opera Don Guanella, Rome, Italy

    Stefano Vicari

Authors
  1. Pietro De Rossi
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  2. Italo Pretelli
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  3. Deny Menghini
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  4. Barbara D’Aiello
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  5. Silvia Di Vara
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  6. Stefano Vicari
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Contributions

DM performed the statistical analyses. PDR wrote the first draft of the manuscript. IP, SDV and BDA assisted in the literature search and preparation of the manuscript. SV supervised research activities and provided the final revision of the manuscript. All the authors approved the final version of the manuscript.

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Correspondence to Stefano Vicari.

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De Rossi, P., Pretelli, I., Menghini, D. et al. Clinical characteristics of children and adolescents with ADHD with or without methylphenidate prescription at their first diagnostic assessment. Eur Arch Psychiatry Clin Neurosci 272, 1437–1442 (2022). https://doi.org/10.1007/s00406-022-01386-9

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  • DOI: https://doi.org/10.1007/s00406-022-01386-9

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