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新诊断为 ADHD 的儿童接受药物治疗和/或心理治疗的预测因素:一项纵向基于人群的队列研究。

Predictors for Receiving Medication and/or Psychotherapy in Children Newly Diagnosed With ADHD: A Longitudinal Population-Based Cohort Study.

机构信息

Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.

Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Germany.

出版信息

J Atten Disord. 2020 Jan;24(2):255-264. doi: 10.1177/1087054718816172. Epub 2018 Dec 6.

Abstract

The aim of this study is to identify characteristics predicting the use of medication and/or psychotherapy after a first ADHD diagnosis. This cohort study was based on German claims data including 12,250 treatment-naïve children aged 5 to 12 years with an incident ADHD diagnosis in 2010. Logistic regression models were used to estimate associations between children's characteristics at first diagnosis and the chosen treatment within the following 5 years. Medication use was associated with male sex, an ADHD diagnosis "with hyperactivity," comorbid depression, and comorbid developmental and conduct disorders. Male sex and comorbid neurotic and somatoform, conduct, and emotional disorders were associated with psychotherapy only. Receiving both treatments-instead of medication only-was associated with comorbid depression, neurotic and somatoform, conduct, and emotional disorders. In case of equal access to both treatment options, patients, for example, with externalizing symptoms were more prone to receive medication and/or psychotherapy than the average child diagnosed with ADHD.

摘要

本研究旨在确定预测首次 ADHD 诊断后药物治疗和/或心理治疗使用的特征。这项队列研究基于德国索赔数据,包括 2010 年 12250 名 5 至 12 岁未经治疗的新发 ADHD 患儿。使用逻辑回归模型来估计首次诊断时儿童特征与接下来 5 年内选择的治疗方法之间的关联。药物治疗与男性、ADHD“伴多动”诊断、共患抑郁以及共患发育和行为障碍相关。仅男性和共患神经症和躯体形式障碍、行为以及情绪障碍与心理治疗相关。与仅接受药物治疗相比,同时接受两种治疗方法(而不是仅药物治疗)与共患抑郁、神经症和躯体形式障碍、行为以及情绪障碍相关。在两种治疗方法均可平等获得的情况下,例如,具有外化症状的患者比平均患有 ADHD 的儿童更有可能接受药物治疗和/或心理治疗。

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