REVIEW OF: Golubchik P et al, J Child Adolesc Psychopharmacol 2021;31(4):310–314

TYPE OF STUDY: Open label, ­uncontrolled

We are always looking for new angles to understand the conditions we treat. ADHD leads to significant academic and social impairments and is highly comorbid with depression and “boredom.” This study examines these associations using the Test of Variables of Attention (TOVA) to see whether methylphenidate (MPH) can help symptoms of depression and boredom in addition to ADHD symptoms.

Researchers enrolled 33 children (24 boys and 9 girls) aged 7–18 years with ADHD and looked at baseline and three-month post-MPH assessments using the parent-rated ADHD Rating Scale (ADHD-RS), the Short Boredom Proneness Scale (SBPS), and the Children’s Depression Inventory (CDI-total and its CDI-AS academic and social function subscale). TOVA was administered only at baseline and assessed omission errors, commission errors, and reaction time. MPH was dosed at 10–54 mg based on efficacy and tolerance.

The study found that higher severity of ADHD, depression, and boredom proneness led to worse reaction time (RT) and RT variability on TOVA. Youths with ADHD and low mood had worse attention span than those without low mood. Moreover, MPH treatment was associated with a significant improvement in not only the core ADHD symptoms, but also in academic and social function (CDI-AS) as well as boredom levels.

These results are limited by the study’s open-label design, its small sample size, the lack of TOVA after MPH, and the inability in this kind of study to calculate an effect size.

CCPR’s Take: Depression and boredom are part of cognitive dysfunction in ADHD, and the role of boredom deserves more investigation. Look for and track these symptoms in patients with ADHD. While more studies are always needed, MPH may be effective beyond core ADHD symptoms of inattention and hyperactivity-impulsivity and help associated depression and boredom.