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一篇关于注意力缺陷多动障碍(ADHD)药物对功能结局影响的文献综述与荟萃分析。

A literature review and meta-analysis on the effects of ADHD medications on functional outcomes.

作者信息

Boland Heidi, DiSalvo Maura, Fried Ronna, Woodworth K Yvonne, Wilens Timothy, Faraone Stephen V, Biederman Joseph

机构信息

Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA.

Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

出版信息

J Psychiatr Res. 2020 Apr;123:21-30. doi: 10.1016/j.jpsychires.2020.01.006. Epub 2020 Jan 27.

Abstract

OBJECTIVE

To conduct a systematic review and meta-analysis of literature from large databases and registries to assess the effects of ADHD medication on associated functional outcomes.

STUDY DESIGN

A literature search was performed in PubMed, PsycINFO, MEDLINE, and Web of Science for articles published prior to January 2019. Sample size, age range, country of origin, medication type, number of functional events and non-events, odds ratios and hazard ratios, and means and standard deviations were extracted. Random-effects meta-analyses were conducted for 21 studies examining functional outcomes.

RESULTS

40 articles were included. The majority suggest a robust protective effect of ADHD medication treatment on mood disorders, suicidality, criminality, substance use disorders, accidents and injuries, traumatic brain injuries, motor vehicle crashes, and educational outcomes. Similarly, the meta-analyses demonstrated a protective effect of medication treatment on academic outcomes, accidents and injuries, and mood disorders.

CONCLUSIONS

These findings suggest that ADHD medication treatments are associated with decreases in the risks for a wide range of ADHD-associated functional outcomes supporting efforts aimed at early diagnosis and treatment of individuals with ADHD.

摘要

目的

对来自大型数据库和登记处的文献进行系统评价和荟萃分析,以评估注意力缺陷多动障碍(ADHD)药物治疗对相关功能结局的影响。

研究设计

在PubMed、PsycINFO、MEDLINE和Web of Science中检索2019年1月之前发表的文章。提取样本量、年龄范围、原产国、药物类型、功能事件和非事件数量、比值比和风险比以及均值和标准差。对21项研究功能结局的研究进行随机效应荟萃分析。

结果

纳入40篇文章。大多数研究表明,ADHD药物治疗对情绪障碍、自杀倾向、犯罪、物质使用障碍、事故和伤害、创伤性脑损伤、机动车碰撞和教育结局具有显著的保护作用。同样,荟萃分析表明药物治疗对学业成绩、事故和伤害以及情绪障碍具有保护作用。

结论

这些发现表明,ADHD药物治疗与降低多种ADHD相关功能结局的风险相关,支持针对ADHD患者进行早期诊断和治疗的努力。

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