000 03397 am a22004453u 4500
042 _adc
100 1 0 _aAsherson, P
_eauthor
_91771
700 1 0 _aJohansson, L
_eauthor
_91772
700 1 0 _aHolland, R
_eauthor
_91773
700 1 0 _aBedding, M
_eauthor
_91774
700 1 0 _aForrester, A
_eauthor
_91775
700 1 0 _aGiannulli, L
_eauthor
_91776
700 1 0 _aGinsberg, Y
_eauthor
_91777
700 1 0 _aHowitt, S
_eauthor
_91778
700 1 0 _aKretzschmar, I
_eauthor
_91779
700 1 0 _aLawrie, SM
_eauthor
_91780
700 1 0 _aMarsh, C
_eauthor
_91781
700 1 0 _aKelly, C
_eauthor
_91782
700 1 0 _aMansfield, M
_eauthor
_91783
700 1 0 _aMcCafferty, C
_eauthor
_91784
700 1 0 _aKhan, K
_eauthor
_91785
700 1 0 _aMuller-Sedgwick, U
_eauthor
_91786
700 1 0 _aStrang, J
_eauthor
_91787
700 1 0 _aWilliamson, G
_eauthor
_91788
700 1 0 _aWilson, L
_eauthor
_91789
700 1 0 _aYoung, S
_eauthor
_91790
700 1 0 _aLandau, S
_eauthor
_91791
700 1 0 _aThomson, L
_eauthor
_91792
245 0 0 _aRandomised controlled trial of the short-term effects of OROS-methylphenidate on ADHD symptoms and behavioural outcomes in young male prisoners with attention deficit hyperactivity disorder (CIAO-II)
260 _c2023-01.
500 _a/pmc/articles/PMC7613969/
500 _a/pubmed/35657651
520 _aBACKGROUND: 20-30% of prisoners meet diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD). Methylphenidate reduces ADHD symptoms but effects in prisoners are uncertain due to comorbid mental health and substance use disorders. AIM: To estimate the efficacy of an Osmotic-Release-Oral-System methylphenidate (OROS-methylphenidate) in reducing ADHD symptoms in young adult prisoners with ADHD. METHODS: An 8-week parallel arm, double-blind, randomised, placebo-controlled trial of OROS-methylphenidate versus placebo in male prisoners (aged 16-25) meeting DSM-5 criteria for ADHD. Primary outcome was ADHD symptoms at 8-weeks using the investigator rated Connors Adult ADHD Rating Scale (CAARS-O). Thirteen secondary outcome measures included emotional dysregulation, mind-wandering, violent attitudes, mental health symptoms, and prison officer and educational staff ratings of behaviour and aggression. FINDINGS: Mean CAARS-O at 8 weeks in the OROS-methylphenidate arm was estimated to be reduced by 0.57 points relative to the Placebo arm (95% CI: -2.41 to 3.56) and non-significant. The responder rate, defined as a 20% reduction in CAARS-O scores was 48.3% for the OROS-methylphenidate arm and 47.9% for the placebo arm. No statistically significant trial arm differences were detected for any of the secondary outcomes. Mean final titrated dose was 53.8 mg in the OROS-methylphenidate arm. CONCLUSIONS: ADHD symptoms did not respond to OROS-methylphenidate in young adult prisoners. The findings do not support routine treatment with OROS-methylphenidate in this population. Further research is needed to evaluate effects of higher average dosing and adherence to treatment, multimodal treatments, and preventative interventions in the community. TRIAL REGISTRATION: EudraCT Number 2015-004271-78; ISRCTN16827947. Database lock 27(th) August 2019
540 _a
546 _aen
690 _aArticle
655 7 _aText
_2local
786 0 _nBr J Psychiatry
856 4 1 _uhttp://dx.doi.org/10.1192/bjp.2022.77
_zConnect to this object online.
999 _c1885
_d1885