Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels Väg 12A, SE-17177, Stockholm, Sweden.
School of Medical Sciences, Örebro University, Örebro, Sweden.
BMC Psychiatry. 2019 Jul 17;19(1):224. doi: 10.1186/s12888-019-2211-7.
Pharmacotherapy is effective in reducing the core symptoms of attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate the concurrent association between pharmacotherapy for ADHD in offspring and depression-related specialty care visits by the parents with a history of depression.
Using data from a variety of Swedish national registers, we conducted a cohort study with 8-year follow-up of 5605 parents (3872 mothers and 1733 fathers) who had a history of depression and an offspring diagnosed with ADHD. The hazard rate for parental depression-related specialty care visits during exposed periods when the offspring was on medication for treatment of ADHD was compared with the hazard rate during unexposed periods when the offspring was off medication. Within-individual comparisons were employed to control for time-constant confounding factors.
Among mothers, the crude rates of depression-related specialty care visits during exposed and unexposed periods were 61.33 and 63.95 per 100 person-years, respectively. The corresponding rates among fathers were 49.23 and 54.65 per 100 person-years. When the same parent was compared with him or herself, fathers showed a decreased hazard rate for depression-related visits during exposed periods when the offspring was on medication for treatment of ADHD as compared to unexposed periods (hazard ratio, 0.79 [95% confidence interval, 0.70 to 0.90]). No statistically significant associations were observed in mothers.
Among parents with a history of depression, pharmacotherapy for ADHD in offspring is concurrently associated with a decreased rate of depression-related specialty care visits in fathers but not in mothers. Future research with refined measures of parental depression and other time-varying familial factors is needed to better understand the mechanisms underlying the association.
药物治疗可有效减轻注意力缺陷多动障碍（ADHD）的核心症状。我们旨在研究父母中有抑郁症病史的子女接受 ADHD 药物治疗与父母因抑郁相关而寻求专科护理就诊之间的并发关联。
利用来自各种瑞典国家登记处的数据，我们对 5605 名父母（3872 名母亲和 1733 名父亲）进行了队列研究，这些父母有抑郁症病史且其子女被诊断患有 ADHD。将子女接受药物治疗 ADHD 的暴露期内父母因抑郁相关而寻求专科护理就诊的风险率与子女停药的非暴露期内的风险率进行比较。采用个体内比较来控制时间不变的混杂因素。
在母亲中，暴露期和非暴露期因抑郁相关而寻求专科护理就诊的粗率分别为 61.33 和 63.95/100 人年。相应的父亲中的粗率分别为 49.23 和 54.65/100 人年。同一父母与其自身比较时，与非暴露期相比，子女接受 ADHD 药物治疗的暴露期父亲因抑郁相关就诊的风险率降低（风险比，0.79 [95%置信区间，0.70 至 0.90]）。在母亲中未观察到统计学显著关联。
在有抑郁症病史的父母中，子女接受 ADHD 药物治疗与父亲因抑郁相关而寻求专科护理就诊的就诊率降低相关，但与母亲无关。需要开展未来研究，采用更精细的父母抑郁措施和其他随时间变化的家庭因素，以更好地理解关联的潜在机制。
