Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Kunming Branch, Taipei City Hospital, Taipei, Taiwan; Branch of Linsen, Chinese Medicine, and Kunming, Taipei City Hospital, Taipei, Taiwan.
J Adolesc Health. 2018 Aug;63(2):233-238. doi: 10.1016/j.jadohealth.2018.02.012. Epub 2018 Jul 1.
Previous studies suggested that patients with attention-deficit hyperactivity disorder (ADHD) were prone to health-risk behaviors and accidents. However, the relationship of ADHD with the risk of traumatic brain injury (TBI) remained uncertain.
Using the Taiwan National Health Insurance Research Database, 72,181 children (aged 3-11 years), adolescents (12-17 years), and young adults (18-29 years) with ADHD and 72,181 age-/sex-matched controls were enrolled between 2001 and 2009, and followed up to the end of 2011 in our study. Those who developed any TBI during the follow-up period were identified.
Children, adolescents, and young adults with ADHD had a higher incidence of developing any TBI (9.8% vs. 2.2%, p < .001), such as skull fracture (.2% vs. .1%, p < .001) and concussion (4.3% vs. 1.0%, p < .001), than the controls did. Cox regression analysis with the adjustment of demographic data, psychiatric comorbidities, and ADHD medications showed that ADHD was related to an increased risk of subsequent TBI (hazard ratio: 4.57, 95% confidence interval: 4.31-4.85), and indicated that long-term use of ADHD medication was associated with a reduced likelihood of subsequent TBI (hazard ratio: .93, 95% confidence interval: .87-.99).
Patients with ADHD had an increased risk of developing any TBI compared with the controls. Long-term use of ADHD medications would reduce this risk. Our findings suggested that the public health government and clinicians should pay more attention to the TBI risk among patients with ADHD, and further indicated the importance of the optimal treatment for ADHD.
先前的研究表明，注意力缺陷多动障碍（ADHD）患者更容易出现健康风险行为和事故。然而，ADHD 与创伤性脑损伤（TBI）风险的关系尚不确定。
使用台湾全民健康保险研究数据库，我们纳入了 2001 年至 2009 年间的 72181 名患有 ADHD 的儿童（3-11 岁）、青少年（12-17 岁）和年轻成年人（18-29 岁）以及 72181 名年龄/性别匹配的对照者，并在研究中对他们进行了随访至 2011 年底。在此期间，我们确定了任何患有 TBI 的患者。
患有 ADHD 的儿童、青少年和年轻成年人发生任何 TBI 的发生率较高（9.8%对 2.2%，p <.001），例如颅骨骨折（0.2%对 0.1%，p <.001）和脑震荡（4.3%对 1.0%，p <.001）。Cox 回归分析在调整人口统计学数据、精神共病和 ADHD 药物治疗后发现，ADHD 与随后发生 TBI 的风险增加相关（风险比：4.57，95%置信区间：4.31-4.85），并且表明长期使用 ADHD 药物治疗与随后发生 TBI 的可能性降低相关（风险比：0.93，95%置信区间：0.87-0.99）。
与对照组相比，患有 ADHD 的患者发生任何 TBI 的风险增加。长期使用 ADHD 药物治疗会降低这种风险。我们的研究结果表明，公共卫生部门和临床医生应更加关注 ADHD 患者的 TBI 风险，并进一步表明 ADHD 最佳治疗的重要性。
