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Attention-deficit hyperactivity disorder (ADHD) is highly prevalent in prison inmates, but pharmacological treatment has not yet been evaluated in this group.
To evaluate osmotic-release oral system (OROS) methylphenidate in adult male long-term prison inmates with ADHD.
Randomised, double-blind, placebo-controlled 5-week trial, followed by 47-week open-label extension in 30 prison inmates with ADHD and comorbid disorders. Primary outcome was level of ADHD symptoms after 5 weeks, evaluated by a masked assessor. Secondary outcomes were self-reported ADHD symptoms, global severity and global functioning throughout the 52-week trial, and post hoc treatment response and numbers needed to treat (NNT) (trial registration: NCT00482313.)
Treatment significantly improved ADHD during the trial (P<0.001; Cohen's d = 2.17), with reduced symptom severity and improved global functioning. The placebo response, cardiovascular measures and adverse events were non-significant; the NNT was 1.1. Attention-deficit hyperactivity disorder symptoms, global severity and global functioning continued to improve during the open-label extension.
Osmotic-release oral system methylphenidate is an effective treatment for adult male prison inmates with ADHD.
Neurofeedback improves mental flexibility and produces a mental state appropriate to situational requirements. Neurofeedback can be an interesting choice of treatment for attention-deficit hyperactivity disorder (ADHD) in conjunction with other treatments or when other treatments fail. It has been shown that both animals and humans can learn to control their brainwaves by operant conditioning. Furthermore, it has been documented that different electro-cortical activities reflect different states of arousal and that a number of disorders, including ADHD, can be discriminated by characteristic patterns on the quantitative electroencephalogram (QEEG). The studies conducted so far have shown that neurofeedback addresses the core symptoms of ADHD. The majority of the research has been done with children and adolescents, and although research shows encouraging results there is a need for further controlled and larger group studies of children and particularly of adults with ADHD.