Placebo Response and Its Determinants in Children with ADHD Across Multiple Observers and Settings: A Randomized Clinical Trial

Overview

Journal Int J Methods Psychiatr Res

Specialty Psychiatry

Date 2017 Jul 1

PMID 28664541

Citations 9

Authors

Weam Fageera

Alexandru Traicu

Sarojini M Sengupta

Marie-Eve Fortier

Zia Choudhry

Aurelie Labbe

Natalie Grizenko

Ridha Joober

Affiliations

Soon will be listed here.

Abstract

This study aims to quantify placebo response (PR) in children with attention deficit hyperactivity disorder (ADHD) as assessed by parents and teachers and to explore some of its determinants. Five hundred and forty children with ADHD (ages 6-12) were recruited to a randomized, double-blind, placebo-controlled crossover trial with methylphenidate. The main outcome variable was Conners' Global Index (CGI), based on assessment of behaviour by parents (CGI-P) and teacher (CGI-T). PR was calculated as the difference between CGI-P/T scores at baseline and placebo week. There was a highly significant PR as assessed by the parents' and teachers' (p < 0.001). The magnitude of PR as assessed by parents was greater (10.57 points) compared to that assessed by teachers (3.93 points). The determinants of PR were different between parents and teachers. For parents, income, marital status, education, maternal smoking during pregnancy, and prior psychostimulant exposure (PPE) showed a significant effect on PR. For teachers, only ethnicity and PPE had an effect. The pattern of PR revealed two distinct profiles that may shed some light on the mechanisms involved in PR. PR in children with ADHD varies depending on the setting of the observations and the evaluator. Several psychosocial factors have been identified as modulators of PR. This is relevant for the design and interpretation of clinical trials and for clinical practice.

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