RESUMO
Background: Children with attention deficit hyperactivity disorder/developmental coordination disorder [ADHD/DCD] suffer from problems associated with gross and fine motor skills. There is no effective pharmacological therapy for such patients. We aimed to assess the impact of methylphenidate [MPH] on motor performance of children with ADHD/DCD
Methods:In this double-blind placebo-controlled, 17 children [12 boys] with ADHD/DCD with a mean age of 7 years 6 months were recruited in Shafa Hospital, Rasht, Iran. The response was defined as >=25% reduction in the total score of ADHD rating scale-IV from the baseline. Sixteen boys entered phase 2 of the study in which the impact of MPH on motor function was determined through a crossover randomized clinical trial. Eligible individuals were scheduled for baseline and two assessment visits after a one-week period of intervention. We used the short form of Bruininks-Oseretsky test [BOT-2] to identify the disability of motor function. Children were randomly assigned to receive MPH or inert ingredients [placebo]. In the second period, medication [MPH/placebo] was crossed over. The effects of MPH were analyzed using chi[2] test for related samples to compare the performance during baseline, placebo, and MPH trials. The results were analyzed using the SPSS software version 16.0
Results: The mean minimal effective dose of MPH per day was 17.3 mg [0.85 mg/kg]. Children with higher ADHD rating scale had a significantly lower standard score in BOT-2 [P=0.03]. Following MPH intake, 26.6% of the children showed clinically significant improvement in motor function. However, the improvement was not statistically different between the MPH and placebo
Conclusion: Although MPH improved ADHD symptoms, problems with motor performance still remained. Further work is required to determine the probable effects of MPH in a higher dosage or in different subtypes of ADHD
RESUMO
Background: Sleep disturbance is a common complaint of patients undergoing methadone maintenance therapy [MMT]. There are limited studies about the effect of different treatments on insomnia due to MMT. In this study, we evaluated the effect of cognitive-behavioral treatment for insomnia [CBTI] on sleep disorders in patients undergoing MMT
Methods: Twenty-two patients with insomnia due to MMT [aged 18-60 years] participated in this randomized double-blind clinical trial. The intervention group received CBTI from a clinical psychologist for 8 weeks, whereas the control group received behavioral placebo therapy [BPT]. The duration of individual sessions was 45 minutes, which was conducted once a week. The primary outcome was sleep disturbance assessed with Pittsburgh Sleep Quality Index [PSQI]. Data were analyzed using SPSS software version 19
Results: Eleven patients were assigned to each group. Two groups were matched according to demographic characteristics [age, marital status, education, and daily methadone doses]. Although PSQI score was significantly reduced during weeks 5 and 8 after both interventions, there was a significant difference in intervention versus time interaction [P<0.02]. The effects of CBTI versus placebo were significantly different [P<0.001]. The time course was also significant [P<0.001]
Conclusion: This study showed that CBTI is more effective than BPT in overall sleep quality. We recommend further studies, with a larger sample, on CBTI in patients undergoing MMT