Effect of ADHD medication on risk of injuries: a preference-based instrumental variable analysis.

Autor: Widding-Havneraas T; Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway. tarjei.widding-havneras@uib.no.; Department of Clinical Medicine, University of Bergen, Bergen, Norway. tarjei.widding-havneras@uib.no., Elwert F; Department of Sociology, University of Wisconsin-Madison, Madison, WI, USA.; Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA., Markussen S; Ragnar Frisch Centre for Economic Research, Oslo, Norway., Zachrisson HD; Department of Special Needs Education, University of Oslo, Oslo, Norway., Lyhmann I; Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway., Chaulagain A; Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway., Bjelland I; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway., Halmøy A; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway., Rypdal K; Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway., Mykletun A; Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway.; Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway.; Department of Community Medicine, University of Tromsø, Tromsø, Norway.; Centre for Work and Mental Health, Nordland Hospital, Bodø, Norway.
Jazyk: angličtina
Zdroj: European child & adolescent psychiatry [Eur Child Adolesc Psychiatry] 2024 Jun; Vol. 33 (6), pp. 1987-1996. Date of Electronic Publication: 2023 Sep 24.
DOI: 10.1007/s00787-023-02294-6
Abstrakt: ADHD is associated with an increased risk of injury. Causal evidence for effects of pharmacological treatment on injuries is scarce. We estimated effects of ADHD medication on injuries using variation in provider preference as an instrumental variable (IV). Using Norwegian registry data, we followed 8051 patients who were diagnosed with ADHD aged 5 to 18 between 2009 and 2011 and recorded their ADHD medication and injuries treated in emergency rooms and emergency wards up to 4 years after diagnosis. Persons with ADHD had an increased risk of injuries compared to the general population (RR 1.35; 95% CI: 1.30-1.39), with higher risk in females (RR 1.47; 95% CI: 1.38-1.56) than males (RR 1.23; 95% CI: 1.18-1.28). The between-clinics variation in provider preference for ADHD medication was large and had a considerable impact on patients' treatment status. There was no causal evidence for protective effects of pharmacological treatment on injuries overall for young individuals with ADHD characterized by milder or atypical symptoms. However, there was an apparent effect of pharmacological treatment over time on the risk of injuries treated at emergency wards in this patient group.
(© 2023. The Author(s).)
Databáze: MEDLINE
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