Effect of Prior Stimulant Treatment for Attention-Deficit/Hyperactivity Disorder on Subsequent Risk for Cigarette Smoking and Alcohol and Drug Use Disorders in Adolescents
| Autor: | Stephen V. Faraone, Timothy E. Wilens, Joel J. Adamson, Diana Westerberg, Mary Schillinger, Michael C. Monuteaux, Joseph Biederman |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Adolescent Substance-Related Disorders medicine.medical_treatment Comorbidity Risk Assessment behavioral disciplines and activities Article mental disorders Confidence Intervals medicine Humans Attention deficit hyperactivity disorder Prospective Studies Sex Distribution Family history Psychiatry Prospective cohort study Proportional Hazards Models business.industry Incidence Smoking Hazard ratio medicine.disease Substance abuse Stimulant Adolescent Behavior Attention Deficit Disorder with Hyperactivity Conduct disorder Case-Control Studies Pediatrics Perinatology and Child Health Central Nervous System Stimulants Female business Alcohol-Related Disorders Attitude to Health Follow-Up Studies |
| Zdroj: | Archives of Pediatrics & Adolescent Medicine. 162:916 |
| ISSN: | 1072-4710 |
| DOI: | 10.1001/archpedi.162.10.916 |
| Popis: | Objective To examine the effects of early stimulant treatment on subsequent risk for cigarette smoking and substance use disorders (SUDs) in adolescents with attention-deficit/hyperactivity disorder (ADHD). Design Case-controlled, prospective, 5-year follow-up study. Setting Massachusetts General Hospital, Boston. Participants Adolescents with and without ADHD from psychiatric and pediatric sources. Blinded interviewers determined all diagnoses using structured interviews. Intervention Naturalistic treatment exposure with psychostimulants for ADHD. Main Outcome Measures We modeled time to onset of SUDs and smoking as a function of stimulant treatment. Results We ascertained 114 subjects with ADHD (mean age at follow-up, 16.2 years) having complete medication and SUD data; 94 of the subjects were treated with stimulants. There were no differences in SUD risk factors between naturalistically treated and untreated groups other than family history of ADHD. We found no increased risks for cigarette smoking or SUDs associated with stimulant therapy. We found significant protective effects of stimulant treatment on the development of any SUD (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.13-0.60; χ 2 113 = 10.57, P = .001) and cigarette smoking (HR, 0.28; 95% CI, 0.14-0.60; χ 2 111 = 10.05, P = .001) that were maintained when controlling for conduct disorder. We found no effects of time to onset or duration of stimulant therapy on subsequent SUDs or cigarette smoking in subjects with ADHD. Conclusion Stimulant therapy does not increase but rather reduces the risk for cigarette smoking and SUDs in adolescents with ADHD. |
| Databáze: | OpenAIRE |
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