Journal of the American Academy of Child & Adolescent Psychiatry
ARTICLESA Feasibility Study of the Children's Medication Algorithm Project (CMAP) Algorithm for the Treatment of ADHD
Section snippets
Subjects
Subjects were 50 children aged 6 to 17 years who were being treated at one of four community mental health centers in Texas. Eligible children had a clinical diagnosis of ADHD made according to the usual practice of the center psychiatrist. Typically, the psychiatrist saw the patient after an intake interview by a master's-level clinician and had access to the written note describing the chief complaint and social history. Most psychiatrists conducted an unstructured, open-ended clinical
Baseline Measures
Table 1 compares the algorithm patients with the historical controls. The groups were not different with regard to ethnicity or comorbid ODD/conduct disorder. In contrast to many research studies, this sample had a high representation of minorities, consistent with their proportion in the community in which the centers were located. The algorithm group showed more severe symptoms at baseline relative to the TAU group (t69.5 = 4.18, p < .0001) and was older (t122 = −3.66, p = .0004). Age and
DISCUSSION
To our knowledge, this was the first attempt to implement and evaluate an evidence-based algorithm for the treatment of ADHD into a community mental health center environment. At a broad level, the algorithm was well accepted and implemented by the psychiatrists. Stimulant medications were used as the drugs of first choice, and the psychiatrists attempted to use a fixed titration strategy to expose patients to the full range of stimulant dosages. This was done in nearly half the cases. All the
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The research was made possible by grants from the Meadows Foundation, the Hogg Foundation for Mental Health, and the Houston Endowment.