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[注意缺陷多动障碍治疗引发精神病的风险]

[Risk of psychosis with treatment for ADHD].

作者信息

Kooij J J S

机构信息

Amsterdam MC, locatie VUMC, afd. Psychiatrie, Amsterdam en PsyQ Den Haag Noord, afd. Kenniscentrum ADHD bij volwassenen, Den Haag.

Contact: J.J.S. Kooij (

出版信息

Ned Tijdschr Geneeskd. 2020 Aug 27;164:D4807.

Abstract

The study by Moran et al. on the risk of psychosis among adolescents in the US who are treated with a stimulant for ADHD is important. This is because ADHD is a common disorder (3-5%), because psychosis often emerges in adolescence, because ADHD and psychosis share increased comorbidity and because ADHD is treated with stimulant medication that may increase the risk of psychosis. This means there is a multifactorial relationship between ADHD and psychosis.The outcome of the study is that stimulants increase the risk of psychosis to a limited extent, i.e. 0.10% for methylphenidate and 0.21% for dexamphetamine. It is recommended to opt for methylphenidate in adolescents with ADHD. This is confirmed by a Swedish registry study that controlled for a history of psychosis and showed that methylphenidate did not increase the incidence of psychosis after one year, regardless of a history of psychosis.

摘要

莫兰等人关于美国使用兴奋剂治疗注意力缺陷多动障碍(ADHD)的青少年患精神病风险的研究很重要。这是因为ADHD是一种常见疾病(3%-5%),因为精神病常出现在青少年时期,因为ADHD和精神病的共病率增加,还因为ADHD用可能增加精神病风险的兴奋剂药物治疗。这意味着ADHD和精神病之间存在多因素关系。该研究的结果是,兴奋剂在有限程度上增加了患精神病的风险,即哌甲酯为0.10%,右旋苯丙胺为0.21%。建议ADHD青少年选择哌甲酯。一项瑞典登记研究证实了这一点,该研究对精神病病史进行了控制,结果表明,无论有无精神病病史,哌甲酯在一年后都不会增加精神病的发病率。

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