Youth Division, Altrecht, Institute for Mental Health, Nieuwe Houtenseweg 2, 3524 SH, Utrecht, The Netherlands,
Eur Child Adolesc Psychiatry. 2014 Feb;23(2):95-102. doi: 10.1007/s00787-013-0432-8. Epub 2013 Jun 4.
To study the association between attention deficit hyperactivity disorder (ADHD) drug use and the incidence of hospitalization due to injuries. A random sample of 150,000 persons (0-18 years) was obtained from the Dutch PHARMO record linkage system. An ADHD medication cohort as well as an up to six age/sex/index date sampled control cohort with no history of ADHD drug use was formed. Differences in incidence of hospitalization due to injuries were stratified for age and sex and compared prior, during and after exposure on ADHD drugs. The overall incidence of hospital admissions for injuries was two times higher in the ADHD medication cohort [incidence rate ratios (IRR) 2.2 (95 % CI 1.6-2.9)]. The incidence rate for injuries during exposure to ADHD drugs was lower in the exposed period compared to the period prior to ADHD drug use, although the difference was not statistically significant [IRR 0.68 (95 % CI 0.29-1.60)]. The relative risk for injuries was almost five times higher in the ADHD medication cohort among those who concomitantly used other psychotropics [IRR 4.8 (95 % CI 1.4-16.9)]. Risk for injuries was highest in 12-18 years olds. Children and adolescents using ADHD medication showed a twofold risk for hospital admissions for injuries. ADHD drug use might diminish the increased injury risk, but still overall risk is higher than in age/sex sampled children and adolescents without treatment with ADHD drugs. Use of ADHD and concomitant psychotropics increases the risk for injuries compared to only ADHD drug use.
研究注意缺陷多动障碍（ADHD）药物使用与因伤住院的发生率之间的关联。从荷兰 PHARMO 记录链接系统中随机抽取了 15 万名（0-18 岁）人员作为样本。形成了 ADHD 药物治疗队列以及至多 6 名年龄/性别/索引日期抽样的无 ADHD 药物使用史的对照队列。根据年龄和性别对因伤住院的发生率差异进行分层，并比较 ADHD 药物暴露前、暴露期间和暴露后的差异。ADHD 药物治疗队列的总体因伤住院发生率是对照组的两倍（发病率比 [IRR] 2.2（95%置信区间 1.6-2.9））。与 ADHD 药物使用前相比，ADHD 药物治疗期间受伤的发生率较低，但差异无统计学意义[IRR 0.68（95%置信区间 0.29-1.60）]。在同时使用其他精神药物的 ADHD 药物治疗队列中，受伤的相对风险几乎高出五倍[IRR 4.8（95%置信区间 1.4-16.9）]。在 12-18 岁年龄组中，受伤风险最高。同时使用 ADHD 药物的儿童和青少年因伤住院的风险增加了两倍。ADHD 药物治疗可能会降低受伤的风险，但总体风险仍高于未接受 ADHD 药物治疗的同年龄/性别抽样儿童和青少年。与仅使用 ADHD 药物相比，使用 ADHD 药物和同时使用精神药物会增加受伤的风险。
