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注意力缺陷多动障碍青少年易受伤的特点:台湾的全国临床数据分析。

Injury-proneness of youth with attention-deficit hyperactivity disorder: a national clinical data analysis in Taiwan.

机构信息

Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Res Dev Disabil. 2013 Mar;34(3):1100-8. doi: 10.1016/j.ridd.2012.11.027. Epub 2013 Jan 20.

Abstract

Limited literature documents injury-proneness of attention-deficit hyperactivity disorder in western population. However, only a few studies prospectively investigated the prediction of ADHD to injuries without considering other psychiatric and physical conditions and there is lack of such data in Asian population. To prospectively examine the prediction of ADHD to the risk of injury in a national sample of Taiwan, we conducted this study with samples including 1965 6-18-year-old youths with newly diagnosis of ADHD from 1999 to 2003, and 7860 sex-, age- and index day-matched non-ADHD controls from Taiwan's National Health Insurance Research Database (1997-2008). Relevant psychiatric and physical disorders, demographics, and medications were also included in the Cox proportional hazard models with injury as the outcome. Our results showed that ADHD cases had a roughly 2-fold and 5-fold higher risk of each injury, and overall injury than controls after considering all confounding factors, respectively. In addition to ADHD, use of anxiolytics, antidepressants, and antipsychotics, and comorbid physical illnesses also predicted the injury prospectively. Our findings strongly support that ADHD predicted injury risks and imply that physicians should take the risk of injury into consideration while prescribing medications other than stimulants to patients with ADHD, especially anxiolytics.

摘要

关于 ADHD 易导致损伤的研究文献有限,主要集中在西方人群。然而,仅有少数研究前瞻性地调查了 ADHD 对损伤的预测作用,并未考虑其他精神和躯体疾病,且亚洲人群的数据较为缺乏。为前瞻性地研究 ADHD 对损伤风险的预测作用,我们对台湾的一个全国性样本进行了此项研究,研究对象包括了 1999 年至 2003 年间新诊断为 ADHD 的 1965 名 6-18 岁青少年 ADHD 患者,以及从台湾全民健康保险研究数据库(1997 年至 2008 年)中匹配性别、年龄和出生日期的 7860 名非 ADHD 对照者。在 Cox 比例风险模型中,将损伤作为结果,同时还纳入了相关的精神和躯体疾病、人口统计学和药物使用情况等混杂因素。研究结果表明,ADHD 患者发生每种损伤和总体损伤的风险分别是非 ADHD 对照组的约 2 倍和 5 倍,在考虑了所有混杂因素后。除 ADHD 外,使用抗焦虑药、抗抑郁药和抗精神病药以及合并躯体疾病也能前瞻性地预测损伤。我们的研究结果强烈支持 ADHD 可预测损伤风险,这提示精神科医生在为 ADHD 患者开具除兴奋剂以外的药物时,应考虑到损伤风险。

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