Scholle Oliver, Jilani Hannah, Riedel Oliver, Banaschewski Tobias, Hadjigeorgiou Charalambos, Hunsberger Monica, Iguacel Isabel, Molnár Dénes, Pala Valeria, Russo Paola, Veidebaum Toomas, Zaqout Mahmoud, Pohlabeln Hermann
1 Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS , Bremen, Germany .
2 Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology-BIPS , Bremen, Germany .
J Child Adolesc Psychopharmacol. 2019 Feb;29(1):58-65. doi: 10.1089/cap.2018.0060. Epub 2018 Nov 16.
To find out whether use of nutritional supplements (NUS) differs between children and adolescents with attention-deficit/hyperactivity disorder (ADHD; medicated or unmedicated), compared with those without the disorder.
We used cross-sectional data from the population-based I.Family study conducted between 2013 and 2014 in eight European countries. Parents completed questionnaires and participated in interviews, for example, on health and medical history of their child. Data from 5067 children and adolescents aged 5-17 years were included. Exposures were medicated (with ADHD-approved medication) and unmedicated ADHD. The outcome was the use of NUS, measured by use of any or multiple different NUS. Multivariable logistic regression adjusted for sociodemographics and health determinants was used to find ADHD-depending differences.
The study sample comprised 4490 children and adolescents without ADHD and 51 medicated and 76 unmedicated subjects with ADHD. Regarding the use of any NUS, no statistically significant differences were found between children and adolescents without ADHD (18%) and those with medicated (18%) or unmedicated ADHD (22%). However, discrepancies appear when considering multiple use of NUS, not reported for any medicated ADHD subject but remarkably often for unmedicated ADHD subjects (13%), resulting in an adjusted odds ratio of 2.6 (95% confidence interval, 1.2-5.6) when compared with those without ADHD (5%).
Children and adolescents who were not using medication for treating ADHD potentially took NUS as oral remedies. Given the potential for a delay of indicated treatments and for use of those NUS which have no proven effectiveness, pediatricians should actively explore whether NUS have been used to treat ADHD core symptoms, and families should be informed that the average effect size has to be considered small.
探究患有注意力缺陷多动障碍（ADHD，无论是否接受药物治疗）的儿童和青少年与未患该疾病的儿童和青少年相比，营养补充剂（NUS）的使用情况是否存在差异。
我们使用了2013年至2014年在八个欧洲国家进行的基于人群的“I.Family研究”的横断面数据。家长完成问卷调查并参与访谈，内容涉及孩子的健康和病史等。纳入了5067名5至17岁儿童和青少年的数据。暴露因素为接受药物治疗（使用经批准用于治疗ADHD的药物）和未接受药物治疗的ADHD。结局指标是NUS的使用情况，通过是否使用任何一种或多种不同的NUS来衡量。采用多变量逻辑回归分析，对社会人口统计学和健康决定因素进行调整，以发现ADHD相关的差异。
研究样本包括4490名未患ADHD的儿童和青少年，以及51名接受药物治疗和76名未接受药物治疗的ADHD患者。在使用任何NUS方面，未患ADHD的儿童和青少年（18%）与接受药物治疗（18%）或未接受药物治疗的ADHD患者（22%）之间未发现统计学上的显著差异。然而，在考虑多种NUS的使用时出现了差异，接受药物治疗的ADHD患者均未报告有这种情况，但未接受药物治疗的ADHD患者中这种情况较为常见（13%），与未患ADHD的患者（5%）相比，调整后的优势比为2.6（95%置信区间，1.2 - 5.6）。
未使用药物治疗ADHD的儿童和青少年可能将NUS作为口服疗法。鉴于可能会延迟必要治疗以及使用那些未证实有效性的NUS，儿科医生应积极探究是否使用NUS来治疗ADHD核心症状，并且应告知家庭，平均效应大小可能较小。
