human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Methylpheni date ( MPH ) is widely prescribed for adults with attention deficit hyperactivity disorder ( ADHD ) , but data on long-term treatment and maintenance of effect are lacking . Osmotic release oral system-methylpheni date ( OROS – MPH ) was evaluated in a 52-wk open-label study in subjects who had previously completed a short-term placebo-controlled trial and short-term open-label extension .  Efficacy was assessed using the investigator- and subject-rated Conners ’ Adult ADHD Rating Scales ( CAARS : O-SV and CAARS : S-S ) , and the Clinical Global Impression – Severity ( CGI-S ) , Sheehan Disability Scale ( SDS ) and Quality of Life Enjoyment and Satisfaction Question naire ( Q-LES-Q ) . Subjects completing ≥52 wk of treatment were eligible for a 4-wk r and omized , placebo-controlled withdrawal phase in which loss of treatment effect was assessed using CAARS : O-SV and CGI-S. In the open-label phase ( n=156 ) , mean CAARS : O-SV score decreased from baseline by 1.9±7.8 ( p<0.01 ) , and small , statistically significant improvements from baseline were observed for CAARS : S-S , CGI-S and SDS . In the double-blind phase ( OROS-MPH , n=23 ; placebo , n=22 ) , CAARS : O-SV increased from double-blind baseline in the OROS-MPH and placebo arms ( 4.0±7.6 vs. 6.5±7.8 , not statistically significant ) . Long-term OROS-MPH treatment was well tolerated , and there was no evidence of withdrawal or rebound after discontinuation . In conclusion , the short-term benefits of OROS-MPH continue during long-term open-label treatment . Maintenance of efficacy in a placebo-controlled withdrawal design remains to be confirmed in larger patient population OBJECTIVE : Little is known about the effect of stimulant treatment in youth with attention-deficit/hyperactivity disorder ( ADHD ) on the subsequent development of comorbid psychiatric disorders . We tested the association between stimulant treatment and the subsequent development of psychiatric comorbidity in a longitudinal sample of patients with ADHD . METHODS : We conducted a case-control , 10-year prospect i ve follow-up study into young-adult years of youth with ADHD . At baseline , we assessed consecutively referred white male children with ( n = 140 ) and without ( n = 120 ) ADHD , aged 6 to 18 years . At the 10-year follow-up , 112 ( 80 % ) and 105 ( 88 % ) of the children in the ADHD and control groups , respectively , were reassessed ( mean age : 22 years ) . We examined the association between stimulant treatment in childhood and adolescence and subsequent comorbid disorders and grade retention by using proportional hazards survival models . RESULTS : Of the 112 participants with ADHD , 82 ( 73 % ) were previously treated with stimulants .  Participants with ADHD who were treated with stimulants were significantly less likely to subsequently develop depressive and anxiety disorders and disruptive behavior and less likely to repeat a grade compared with participants with ADHD who were not treated . CONCLUSIONS : We found evidence that stimulant treatment decreases the risk for subsequent comorbid psychiatric disorders and academic failure in youth with ADHD There is increased global recognition of attention deficit hyperactivity disorder ( ADHD ) as a serious medical condition with long-term consequences . Although originally conceived of as a childhood disorder , ADHD is being increasingly recognized in adults . Individual geographic regions may have specific interests and objectives for the study of ADHD . A systematic review of  long-term outcomes ( LTOs ) in ADHD was conducted to evaluate research on ADHD LTOs  on a global scale . Studies that were at least 2 years in duration were examined . A total of 351 studies were identified in the final analysis . We identified nine outcomes of interest and classified studies by specific geographical regions , age groups studied and study design by region and over time . Published studies of LTOs in ADHD have increased in all geographical regions over the past three decades , with a peak number of 42 publications in 2008 . This rise in publications on ADHD LTOs may reflect a rise in global interest and recognition of consequences and impairment associated with ADHD . Although many world regions have published on ADHD LTOs , the majority of studies have emerged from the US and Canada , followed by Europe . While investigators in the US and Canada were predominantly interested in drug addiction as a LTO , European research ers were more interested in antisocial behavior , and Eastern Asian investigators focused on both of these LTOs as well as self-esteem . Geographical differences in the focus of ADHD LTO studies may reflect regional variations in cultural values . Proportionally fewer prospect i ve longitudinal studies and proportionally more retrospective and cross-sectional studies have been published in more recent decades . Finally , more studies focusing on ADHD in adolescents and adults have been conducted in recent years , and particularly adolescents in Eastern Asia . These changes in basic study design may reflect an increase in the recognition that ADHD is a lifetime chronic disorder . This systematic review analysis of publication trends in ADHD LTOs reflects geographically based interests that change over time Objective : To evaluate the long-term safety of OROS methylpheni date in the management of attention-deficit/hyperactivity disorder ( ADHD ) in adults . Methods : This multicenter , open-label , dose-titration , flexible dose study enrolled adults with ADHD for 6 or 12 months of treatment with OROS methylpheni date . Dosing began at 36 mg/d , with titration in 18-mg increments every 7 days until a predefined outcome ( efficacy threshold , maximum dosage of 108 mg/d , or limiting adverse event ) . Dose reduction occurred for prespecified reasons , and the subjects discontinued if unable to tolerate 36 mg/d . Assessment s included ADHD symptoms , adverse events , vital signs , and laboratory results . Results : A total of 550 subjects received treatment ( 52 % were men ; mean age , 39 years ; range , 18 - 65 years ) , and 57 % ( 146/258 ) and 44 % ( 129/292 ) completed their 6 or 12 months of treatment with mean duration s of 128 and 213 days , respectively . The final prescribed dosages were 36 mg/d ( 22.4 % ) , 54 mg/d ( 25.1 % ) , 72 mg/d ( 22.0 % ) , 90 mg/d ( 17.1 % ) , and 108 mg/d ( 13.5 % ) . Modest increases from baseline to final visit were observed in mean systolic ( 2.6 mm Hg ) and diastolic ( 1.9 mm Hg ) blood pressure and pulse ( 4.1 beats per minute ) . The mean weight decreased by 2.3 kg . No clinical ly meaningful changes in laboratory values or electrocardiogram parameters were observed other than increased heart rate . Most common adverse events included decreased appetite ( 26.7 % ) , headache ( 24.0 % ) , and insomnia ( 20.7 % ) . No serious adverse event was considered related to study medication . Several measures of efficacy indicated improvement during the study . Conclusions : OROS methylpheni date , in the flexible dosage range from 36 to 108 mg/d , was well tolerated for up to 1 year in adults with ADHD BACKGROUND Attention-deficit hyperactivity disorder ( ADHD ) is highly prevalent in prison inmates , but pharmacological treatment has not yet been evaluated in this group . AIMS To evaluate osmotic-release oral system ( OROS ) methylpheni date in adult male long-term prison inmates with ADHD . METHOD R and omised , 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 . ) RESULTS 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 . CONCLUSIONS Osmotic-release oral system methylpheni date is an effective treatment for adult male prison inmates with ADHD Abstract Objectives . Treatment investigations with methylpheni date in adults with ADHD focus preferentially on the classical psychopathology : inattention , hyperactivity and impulsivity . ADHD-associated emotional symptoms , which are frequently present at least in ADHD sub population s , were studied rarely . The vast majority of the placebo-controlled trials had observation periods between 4 and 8 weeks . To assess the medium- to long-term effects of extended release methylpheni date ( MPH-ER ) on emotional symptoms and other psychopathology frequently seen in ADHD patients , we conducted a large-scale , multicenter treatment study . Methods . We performed a r and omised , 24-week , double-blind , placebo-controlled study in adults with ADHD . The diagnosis was made on the basis of the DSM-IV criteria , which were confirmed by clinical history and a structured psychopathological interview and the use of rating instruments . 363 patients were r and omized to MPH-ER or placebo at a ratio of 2:1 . The duration of the titration period was 5 weeks followed by a maintainance phase of 19 weeks . The efficacy measures were the observer rated 10-item Emotional Dysregulation Scale ( EDS ) derived from the Wender-Reimherr Adult Attention Deficit Disorder Scale ( WRAADDS ) and a self-report , six-item Emotional Lability Scale ( ELS ) extracted from the long version of the Conners Adult ADHD Self Report Scale ( CAARS : S : L ) . In addition we used the SCL-90-R for the assessment of ADHD associated and comorbid psychopathology . Results . MPH-ER was statistically superior to placebo in reducing emotional symptoms as assessed by the EDS and the ELS . Obsessive-compulsive symptoms and those of problems with self-concept declined until the end of the observation period . The decline was more pronounced in MPH-ER treated individuals . The effects remained robust during the entire maintenance period until week 24 . Symptoms of anxiety , depression , anger and hostility , phobia , paranoid ideations and psychoticism were not improved . Conclusions . MPH-ER appears to be an efficacious treatment for emotional symptoms with ADHD . Also obsessive-compulsive symptoms and problems with self-concept were affected positively Treatment with psychostimulant medication has been shown to improve scholastic functioning in children with attention-deficit/hyperactivity disorder ( ADHD ) . However , the extent to which long-term academic gains are apparent in those having received such treatment remains elusive . This study examined prospect ively the relationship of childhood stimulant treatment to academic functioning during adolescence . Children ( n = 169 ) were initially recruited and diagnosed with ADHD when they were 7 - 11 years old . A sub sample of those with childhood ADHD ( n = 90 ) was reevaluated on average 9.13 ( SD = 1.5 ) years later . Prob and s who did and did not receive treatment with stimulant medication were compared to each other and to a never-ADHD comparison group ( n = 80 ) on three subtests from the Wechsler Individual Achievement Test-II ( WIAT-II ) , as well as high school grade point average ( GPA ) and number of retentions in school as derived from school records . Analyses of covariance controlling for severity of childhood ADHD symptoms indicated that prob and s treated with psychostimulant medication achieved better academic outcomes , as measured by WIAT-II subtests and high school GPA , than those not treated with psychostimulants ( p < .05 ) . However , treated prob and s did not fare as well as the never-ADHD comparison group . Psychostimulant treatment for children with ADHD may benefit long-term adolescent academic performance , although the extent of improvement is likely to vary as a function of multiple factors OBJECTIVES To determine any long-term effects , 6 and 8 years after childhood enrollment , of the r and omly assigned 14-month treatments in the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder ( MTA ; N = 436 ) ; to test whether attention-deficit/hyperactivity disorder ( ADHD ) symptom trajectory through 3 years predicts outcome in subsequent years ; and to examine functioning level of the MTA adolescents relative to their non-ADHD peers ( local normative comparison group ; N = 261 ) . METHOD Mixed-effects regression models with planned contrasts at 6 and 8 years tested a wide range of symptom and impairment variables assessed by  parent , teacher , and youth report . RESULTS In nearly every analysis , the originally r and omized treatment groups did not differ significantly on repeated measures or newly analyzed variables ( e.g. , grade s earned in school , 
    Output:
    
agent
These observational studies also showed positive correlations between early recognition of the disorder , stimulant treatment during childhood and favorable long-term outcome in adult ADHD patients .
In conclusion , stimulant therapy of ADHD has long-term beneficial effects and is well tolerated .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Methylpheni date ( MPH ) is widely prescribed for adults with attention deficit hyperactivity disorder ( ADHD ) , but data on long-term treatment and maintenance of effect are lacking . Osmotic release oral system-methylpheni date ( OROS – MPH ) was evaluated in a 52-wk open-label study in subjects who had previously completed a short-term placebo-controlled trial and short-term open-label extension .  Efficacy was assessed using the investigator- and subject-rated Conners ’ Adult ADHD Rating Scales ( CAARS : O-SV and CAARS : S-S ) , and the Clinical Global Impression – Severity ( CGI-S ) , Sheehan Disability Scale ( SDS ) and Quality of Life Enjoyment and Satisfaction Question naire ( Q-LES-Q ) . Subjects completing ≥52 wk of treatment were eligible for a 4-wk r and omized , placebo-controlled withdrawal phase in which loss of treatment effect was assessed using CAARS : O-SV and CGI-S. In the open-label phase ( n=156 ) , mean CAARS : O-SV score decreased from baseline by 1.9±7.8 ( p<0.01 ) , and small , statistically significant improvements from baseline were observed for CAARS : S-S , CGI-S and SDS . In the double-blind phase ( OROS-MPH , n=23 ; placebo , n=22 ) , CAARS : O-SV increased from double-blind baseline in the OROS-MPH and placebo arms ( 4.0±7.6 vs. 6.5±7.8 , not statistically significant ) . Long-term OROS-MPH treatment was well tolerated , and there was no evidence of withdrawal or rebound after discontinuation . In conclusion , the short-term benefits of OROS-MPH continue during long-term open-label treatment . Maintenance of efficacy in a placebo-controlled withdrawal design remains to be confirmed in larger patient population OBJECTIVE : Little is known about the effect of stimulant treatment in youth with attention-deficit/hyperactivity disorder ( ADHD ) on the subsequent development of comorbid psychiatric disorders . We tested the association between stimulant treatment and the subsequent development of psychiatric comorbidity in a longitudinal sample of patients with ADHD . METHODS : We conducted a case-control , 10-year prospect i ve follow-up study into young-adult years of youth with ADHD . At baseline , we assessed consecutively referred white male children with ( n = 140 ) and without ( n = 120 ) ADHD , aged 6 to 18 years . At the 10-year follow-up , 112 ( 80 % ) and 105 ( 88 % ) of the children in the ADHD and control groups , respectively , were reassessed ( mean age : 22 years ) . We examined the association between stimulant treatment in childhood and adolescence and subsequent comorbid disorders and grade retention by using proportional hazards survival models . RESULTS : Of the 112 participants with ADHD , 82 ( 73 % ) were previously treated with stimulants .  Participants with ADHD who were treated with stimulants were significantly less likely to subsequently develop depressive and anxiety disorders and disruptive behavior and less likely to repeat a grade compared with participants with ADHD who were not treated . CONCLUSIONS : We found evidence that stimulant treatment decreases the risk for subsequent comorbid psychiatric disorders and academic failure in youth with ADHD There is increased global recognition of attention deficit hyperactivity disorder ( ADHD ) as a serious medical condition with long-term consequences . Although originally conceived of as a childhood disorder , ADHD is being increasingly recognized in adults . Individual geographic regions may have specific interests and objectives for the study of ADHD . A systematic review of  long-term outcomes ( LTOs ) in ADHD was conducted to evaluate research on ADHD LTOs  on a global scale . Studies that were at least 2 years in duration were examined . A total of 351 studies were identified in the final analysis . We identified nine outcomes of interest and classified studies by specific geographical regions , age groups studied and study design by region and over time . Published studies of LTOs in ADHD have increased in all geographical regions over the past three decades , with a peak number of 42 publications in 2008 . This rise in publications on ADHD LTOs may reflect a rise in global interest and recognition of consequences and impairment associated with ADHD . Although many world regions have published on ADHD LTOs , the majority of studies have emerged from the US and Canada , followed by Europe . While investigators in the US and Canada were predominantly interested in drug addiction as a LTO , European research ers were more interested in antisocial behavior , and Eastern Asian investigators focused on both of these LTOs as well as self-esteem . Geographical differences in the focus of ADHD LTO studies may reflect regional variations in cultural values . Proportionally fewer prospect i ve longitudinal studies and proportionally more retrospective and cross-sectional studies have been published in more recent decades . Finally , more studies focusing on ADHD in adolescents and adults have been conducted in recent years , and particularly adolescents in Eastern Asia . These changes in basic study design may reflect an increase in the recognition that ADHD is a lifetime chronic disorder . This systematic review analysis of publication trends in ADHD LTOs reflects geographically based interests that change over time Objective : To evaluate the long-term safety of OROS methylpheni date in the management of attention-deficit/hyperactivity disorder ( ADHD ) in adults . Methods : This multicenter , open-label , dose-titration , flexible dose study enrolled adults with ADHD for 6 or 12 months of treatment with OROS methylpheni date . Dosing began at 36 mg/d , with titration in 18-mg increments every 7 days until a predefined outcome ( efficacy threshold , maximum dosage of 108 mg/d , or limiting adverse event ) . Dose reduction occurred for prespecified reasons , and the subjects discontinued if unable to tolerate 36 mg/d . Assessment s included ADHD symptoms , adverse events , vital signs , and laboratory results . Results : A total of 550 subjects received treatment ( 52 % were men ; mean age , 39 years ; range , 18 - 65 years ) , and 57 % ( 146/258 ) and 44 % ( 129/292 ) completed their 6 or 12 months of treatment with mean duration s of 128 and 213 days , respectively . The final prescribed dosages were 36 mg/d ( 22.4 % ) , 54 mg/d ( 25.1 % ) , 72 mg/d ( 22.0 % ) , 90 mg/d ( 17.1 % ) , and 108 mg/d ( 13.5 % ) . Modest increases from baseline to final visit were observed in mean systolic ( 2.6 mm Hg ) and diastolic ( 1.9 mm Hg ) blood pressure and pulse ( 4.1 beats per minute ) . The mean weight decreased by 2.3 kg . No clinical ly meaningful changes in laboratory values or electrocardiogram parameters were observed other than increased heart rate . Most common adverse events included decreased appetite ( 26.7 % ) , headache ( 24.0 % ) , and insomnia ( 20.7 % ) . No serious adverse event was considered related to study medication . Several measures of efficacy indicated improvement during the study . Conclusions : OROS methylpheni date , in the flexible dosage range from 36 to 108 mg/d , was well tolerated for up to 1 year in adults with ADHD BACKGROUND Attention-deficit hyperactivity disorder ( ADHD ) is highly prevalent in prison inmates , but pharmacological treatment has not yet been evaluated in this group . AIMS To evaluate osmotic-release oral system ( OROS ) methylpheni date in adult male long-term prison inmates with ADHD . METHOD R and omised , 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 . ) RESULTS 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 . CONCLUSIONS Osmotic-release oral system methylpheni date is an effective treatment for adult male prison inmates with ADHD Abstract Objectives . Treatment investigations with methylpheni date in adults with ADHD focus preferentially on the classical psychopathology : inattention , hyperactivity and impulsivity . ADHD-associated emotional symptoms , which are frequently present at least in ADHD sub population s , were studied rarely . The vast majority of the placebo-controlled trials had observation periods between 4 and 8 weeks . To assess the medium- to long-term effects of extended release methylpheni date ( MPH-ER ) on emotional symptoms and other psychopathology frequently seen in ADHD patients , we conducted a large-scale , multicenter treatment study . Methods . We performed a r and omised , 24-week , double-blind , placebo-controlled study in adults with ADHD . The diagnosis was made on the basis of the DSM-IV criteria , which were confirmed by clinical history and a structured psychopathological interview and the use of rating instruments . 363 patients were r and omized to MPH-ER or placebo at a ratio of 2:1 . The duration of the titration period was 5 weeks followed by a maintainance phase of 19 weeks . The efficacy measures were the observer rated 10-item Emotional Dysregulation Scale ( EDS ) derived from the Wender-Reimherr Adult Attention Deficit Disorder Scale ( WRAADDS ) and a self-report , six-item Emotional Lability Scale ( ELS ) extracted from the long version of the Conners Adult ADHD Self Report Scale ( CAARS : S : L ) . In addition we used the SCL-90-R for the assessment of ADHD associated and comorbid psychopathology . Results . MPH-ER was statistically superior to placebo in reducing emotional symptoms as assessed by the EDS and the ELS . Obsessive-compulsive symptoms and those of problems with self-concept declined until the end of the observation period . The decline was more pronounced in MPH-ER treated individuals . The effects remained robust during the entire maintenance period until week 24 . Symptoms of anxiety , depression , anger and hostility , phobia , paranoid ideations and psychoticism were not improved . Conclusions . MPH-ER appears to be an efficacious treatment for emotional symptoms with ADHD . Also obsessive-compulsive symptoms and problems with self-concept were affected positively Treatment with psychostimulant medication has been shown to improve scholastic functioning in children with attention-deficit/hyperactivity disorder ( ADHD ) . However , the extent to which long-term academic gains are apparent in those having received such treatment remains elusive . This study examined prospect ively the relationship of childhood stimulant treatment to academic functioning during adolescence . Children ( n = 169 ) were initially recruited and diagnosed with ADHD when they were 7 - 11 years old . A sub sample of those with childhood ADHD ( n = 90 ) was reevaluated on average 9.13 ( SD = 1.5 ) years later . Prob and s who did and did not receive treatment with stimulant medication were compared to each other and to a never-ADHD comparison group ( n = 80 ) on three subtests from the Wechsler Individual Achievement Test-II ( WIAT-II ) , as well as high school grade point average ( GPA ) and number of retentions in school as derived from school records . Analyses of covariance controlling for severity of childhood ADHD symptoms indicated that prob and s treated with psychostimulant medication achieved better academic outcomes , as measured by WIAT-II subtests and high school GPA , than those not treated with psychostimulants ( p < .05 ) . However , treated prob and s did not fare as well as the never-ADHD comparison group . Psychostimulant treatment for children with ADHD may benefit long-term adolescent academic performance , although the extent of improvement is likely to vary as a function of multiple factors OBJECTIVES To determine any long-term effects , 6 and 8 years after childhood enrollment , of the r and omly assigned 14-month treatments in the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder ( MTA ; N = 436 ) ; to test whether attention-deficit/hyperactivity disorder ( ADHD ) symptom trajectory through 3 years predicts outcome in subsequent years ; and to examine functioning level of the MTA adolescents relative to their non-ADHD peers ( local normative comparison group ; N = 261 ) . METHOD Mixed-effects regression models with planned contrasts at 6 and 8 years tested a wide range of symptom and impairment variables assessed by  parent , teacher , and youth report . RESULTS In nearly every analysis , the originally r and omized treatment groups did not differ significantly on repeated measures or newly analyzed variables ( e.g. , grade s earned in school , 
    Output:
    