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注意缺陷多动障碍青少年男女的抑郁和自杀行为:来自理赔数据的证据。

Depression and Suicidal Behavior in Young Adult Men and Women With ADHD: Evidence From Claims Data.

机构信息

Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 22 Northeast Drive, Hershey, PA 17033.

Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA.

出版信息

J Clin Psychiatry. 2020 Sep 22;81(6):19m13130. doi: 10.4088/JCP.19m13130.

Abstract

OBJECTIVE

This study used commercial claims data to examine the effects of ADHD and sex on the prevalence of depression, suicidal ideation, and suicide attempts in a sample of young adult men and women (aged 18-25 years) with and without attention-deficit/hyperactivity disorder (ADHD). Patterns of treatment use for these conditions was also explored.

METHODS

Young adults with ADHD (162,263 women and 225,705 men) having at least 2 claims with the International Classification of Diseases, Ninth Revision (ICD-9), code for ADHD and a sex- and age-matched group of young adults without an ICD-9 code for ADHD (162,263 women and 225,705 men) were identified. The prevalence of ICD-9 depression and suicidal behavior along with the use and cost of related treatment were compared between young adults with and without ADHD using 2014 claims data.

RESULTS

Compared to young adults without ADHD, young adults with ADHD were more frequently identified with depression, suicidal ideation, and suicide attempts. Depression and suicidal ideation were identified more frequently among women with ADHD compared to all other groups. Young adults with ADHD were more frequently engaged in outpatient and inpatient mental health care compared to young adults without ADHD (P < .0001 in each instance). Furthermore, overall costs of outpatient and inpatient care were greater among young adults with ADHD compared to young adults without ADHD (P < .0001 in each instance).

CONCLUSIONS

These findings highlight the substantial burden of depression and suicidal behavior among young adults with ADHD, particularly women, and underlie the need for more research focused on mitigating risk for depression and suicidal behavior among both men and women with ADHD.

摘要

目的

本研究使用商业索赔数据,在患有和不患有注意力缺陷/多动障碍(ADHD)的年轻成年男女(年龄在 18-25 岁之间)样本中,考察 ADHD 及性别对抑郁、自杀意念和自杀企图发生率的影响。还探讨了这些疾病的治疗模式。

方法

确定了患有 ADHD(女性 162263 人,男性 225705 人)且至少有 2 次 ICD-9 编码为 ADHD 的索赔记录,且性别和年龄与无 ADHD 的 ICD-9 编码的年轻成年人相匹配的年轻成年人(女性 162263 人,男性 225705 人)。使用 2014 年的索赔数据,比较了患有和不患有 ADHD 的年轻成年人中 ICD-9 抑郁和自杀行为的发生率以及相关治疗的使用和费用。

结果

与无 ADHD 的年轻成年人相比,患有 ADHD 的年轻成年人更频繁地被诊断为抑郁、自杀意念和自杀企图。与所有其他群体相比,患有 ADHD 的女性中抑郁和自杀意念的发生率更高。与无 ADHD 的年轻成年人相比,患有 ADHD 的年轻成年人更频繁地接受门诊和住院心理健康护理(每种情况下均 P <.0001)。此外,与无 ADHD 的年轻成年人相比,患有 ADHD 的年轻成年人的门诊和住院治疗总成本更高(每种情况下均 P <.0001)。

结论

这些发现强调了 ADHD 年轻成年人,尤其是女性中抑郁和自杀行为的巨大负担,这突显了需要更多地研究如何降低 ADHD 男性和女性的抑郁和自杀行为风险。

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