Evidence map›Paper›PMID 35657651›Full record

Trial reportThe British journal of psychiatry : the journal of mental science2023

Randomised controlled trial of the short-term effects of osmotic-release oral system methylphenidate on symptoms and behavioural outcomes in young male prisoners with attention deficit hyperactivity disorder: CIAO-II study.

Philip J Asherson, Lena Johansson, Rachel Holland, Megan Bedding, Andrew Forrester, Laura Giannulli, Ylva Ginsberg, Sheila Howitt, Imogen Kretzschmar, Stephen M Lawrie and 12 more

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The British journal of psychiatry : the journal of mental science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Article
  6. Article
  7. The need for speed? Exploring the risks and benefits of pharmacological treatment for adult ADHD in prisons.Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law · 2024
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 7 institutions in 2 countries.

Philip J AshersonSocial Genetic and Developmental Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.ORCID 0000-0003-2667-2254
Lena JohanssonSocial Genetic and Developmental Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.ORCID 0000-0002-4473-1134
Rachel HollandDepartment of Biostatistics and Health Informatics, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.
Megan BeddingSocial Genetic and Developmental Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.
Andrew ForresterDivision of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK; and Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.
Laura GiannulliDivision of Psychiatry, The University of Edinburgh, UK.
Ylva GinsbergDepartment of Clinical Neuroscience, Karolinska Institute, Sweden.
Sheila HowittDivision of Psychiatry, The University of Edinburgh, UK; and Forensic Psychiatry, NHS State Hospitals Board for Scotland, UK.
Imogen KretzschmarSocial Genetic and Developmental Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.
Stephen M LawrieDivision of Psychiatry, The University of Edinburgh, UK.ORCID 0000-0002-2444-5675
Craig MarshForensic Psychiatry, NHS Forth Valley Health Board, UK.
Caroline KellyDivision of Psychiatry, The University of Edinburgh, UK.
Megan MansfieldSocial Genetic and Developmental Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.
Clare McCaffertyForensic Nursing, NHS State Hospitals Board for Scotland, UK.
Khuram KhanForensic Psychiatry, NHS State Hospitals Board for Scotland, UK.
Ulrich Müller-SedgwickAdult ADHD Service, Barnet, Enfield and Haringey Mental Health NHS Trust, UK.
John StrangDepartment of Addictions, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.
Grace WilliamsonSocial Genetic and Developmental Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.
Lauren WilsonSocial Genetic and Developmental Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.
Susan YoungPsychology Services, Psychology Services Limited, UK.
Sabine LandauDepartment of Biostatistics and Health Informatics, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.
Lindsay D G ThomsonForensic Psychiatry, NHS State Hospitals Board for Scotland, UK; and Division of Psychiatry, The University of Edinburgh, UK.ORCID 0000-0002-0748-6547
King's College London · GBUniversity of Edinburgh · GBNHS Education for Scotland · GBState Hospital · GBBarnet Enfield and Haringey Mental Health Trust · GBKarolinska Institutet · SENHS Forth Valley · GB

Funding

Department of Health 14/23/17Efficacy and Mechanism Evaluation Programme 14/23/17Medical Research Council
6 · The paper itself

Abstract

backgroundResearch has shown that 20-30% of prisoners meet the diagnostic criteria for attention-deficit hyperactivity disorder (ADHD). Methylphenidate reduces ADHD symptoms, but effects in prisoners are uncertain because of comorbid mental health and substance use disorders.

aimsTo estimate the efficacy of an osmotic-release oral system methylphenidate (OROS-methylphenidate) in reducing ADHD symptoms in young adult prisoners with ADHD.

methodWe conducted an 8-week parallel-arm, double-blind, randomised placebo-controlled trial of OROS-methylphenidate versus placebo in male prisoners (aged 16-25 years) meeting the 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 outcomes were measured, including emotional dysregulation, mind wandering, violent attitudes, mental health symptoms, and prison officer and educational staff ratings of behaviour and aggression.

resultsIn the OROS-methylphenidate arm, mean CAARS-O score at 8 weeks 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 score, 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.

conclusionsADHD 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, multi-modal treatments and preventative interventions in the community.

Indexed as

Attention Deficit Disorder with HyperactivityCentral Nervous System StimulantsMethylphenidatePrisonersDelayed-Action PreparationsDouble-Blind MethodHumansMaleTreatment OutcomeYoung AdultCentral Nervous System StimulantsDelayed-Action PreparationsMethylphenidateattention-deficit hyperactivity disordersforensic mental health servicesmethylphenidatePrisonersrandomised controlled trial

Identifiers

PMID35657651
PMCPMC7613969
OpenAlexW4281765324

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.