Psychological Medicine

Research Article

Which boys respond to stimulant medication? A controlled trial of methylphenidate in boys with disruptive behaviour

E. Taylora1 c1, R. Schachara1 p1, G. Thorleya1, H. M. Wieselberga1, B. Everitta1 p2 and M. Ruttera1

a1 Department of Child and Adolescent Psychiatry, Institute of Psychiatry, London

Abstract

Thirty-eight boys, referred for psychiatric treatment because of serious problems of behaviour, underwent a double-blind, placebo-controlled, crossover trial of methylphenidate and placebo. Methylphenidate was an effective treatment over a 3-week period. A good response to methylphenidate was predicted by higher levels of inattentive and restless behaviour, impaired performance on tests of attention, clumsiness, younger age and by the absence of symptoms of overt emotional disorder. DSM-III and ICD-9 diagnoses of ‘hyperactivity’ were not good predictors. The results support the validity of a construct of hyperactivity in describing childhood psychopathology, but emphasize the need for a refinement of diagnostic criteria.

Correspondence:

c1 Address for correspondence: Dr E. Taylor, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF.

p1 Present address: Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, Canada.

p2 Present address: Department of Biometrics, Institute of Psychiatry, London.

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