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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2011; 11: 65.
Published online Apr 19, 2011. doi:  10.1186/1471-244X-11-65
PMCID: PMC3111344
Clinical symptoms and performance on the continuous performance test in children with attention deficit hyperactivity disorder between subtypes: a natural follow-up study for 6 months
Liang-Jen Wang,1,2 Yu-Shu Huang,3,4 Yuan-Lin Chiang,1,3 Chen-Cheng Hsiao,1,3 Zong-Yi Shang,1 and Chih-Ken Chencorresponding author1,3,5
1Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
2Master of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
3Chang Gung University School of Medicine, Taoyuan, Taiwan
4Department of Psychiatry, Chang Gung Memorial Hospital at Linko, Taoyuan, Taiwan
5Division of Mental Health & Drug Abuse Research, National Health Research Institutes, Miaoli, Taiwan
corresponding authorCorresponding author.
Liang-Jen Wang: anus78/at/cgmh.org.tw; Yu-Shu Huang: hu1109s/at/yahoo.com.tw; Yuan-Lin Chiang: chiang.yuanlin/at/yahoo.com.tw; Chen-Cheng Hsiao: q56320/at/cgmh.org.tw; Zong-Yi Shang: zongmhiau/at/gmail.com; Chih-Ken Chen: kenchen/at/cgmh.org.tw
Received July 7, 2010; Accepted April 19, 2011.
Abstract
Background
The aims of this study were to determine the time course of improvements in attention deficit hyperactivity disorder (ADHD) clinical symptoms and neurocognitive function in a realistic clinical setting, and the differences in ADHD symptom improvement using different classifications of ADHD subtypes.
Methods
The Child Behavior Checklist (CBCL) was completed by parents of ADHD children at the initial visit. The computerized Continuous Performance Test (CPT), Swanson, Nolan, and Pelham, and Version IV Scale for ADHD (SNAP-IV), and ADHD Rating Scale (ADHD-RS) were performed at baseline, one month, three months, and six months later, respectively. Patient care including drug therapy was performed at the discretion of the psychiatrist. The ADHD patients were divided into DSM-IV subtypes (Inattentive, Hyperactive-impulsive and Combined type), and were additionally categorized into aggressive and non-aggressive subtypes by aggression scale in CBCL for comparisons.
Results
There were 50 ADHD patients with a mean age of 7.84 ± 1.64 years; 15 of them were inattentive type, 11 were hyperactive-impulsive type, and 24 were combined type. In addition, 28 of the ADHD patients were grouped into aggressive and 22 into non-aggressive subtypes. There were significant improvements in clinical symptoms of hyperactivity and inattention, and impulsivity performance in CPT during the 6-month treatment. The clinical hyperactive symptoms were significantly different between ADHD patients sub-grouping both by DSM-IV and aggression. Non-aggressive patients had significantly greater changes in distraction and impulsivity performances in CPT from baseline to month 6 than aggressive patients.
Conclusions
We found that ADHD symptoms, which included impulsive performances in CPT and clinical inattention and hyperactivity dimensions, had improved significantly over 6 months under pragmatic treatments. The non-aggressive ADHD patients might have a higher potential for improving in CPT performance than aggressive ones. However, it warrant further investigation whether the different classifications of ADHD patients could be valid for predicting the improvements in ADHD patients' clinical symptoms and neurocognitive performance.
Keywords: ADHD, subtype, aggressive, Continuous Performance Test, clinical symptoms
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