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Attention Deficit/Hyperactivity Disorder and risk for non-affective psychotic disorder: The role of ADHD medication and comorbidity, and sibling comparison
Schizophrenia Research ( IF 3.6 ) Pub Date : 2020-04-01 , DOI: 10.1016/j.schres.2020.01.021
Emma Björkenstam 1 , Matthias Pierce 2 , Charlotte Björkenstam 3 , Christina Dalman 4 , Kyriaki Kosidou 4
Affiliation  

Attention Deficit/Hyperactivity Disorder (ADHD) is the most common psychiatric disorder in childhood. It is unclear whether ADHD increases the risk of non-affective psychotic disorder (NAPD). The study included a matched cohort, drawn from all born in Sweden 1987-1991 (n = 548,852). ADHD was defined as ICD diagnosis and/or prescription of ADHD medication. We distinguished between stimulants and non-stimulants, and usage duration (<1 year, 1-2 years and ≥2 years). We calculated odds ratios (OR) with 95% confidence intervals (CI) for NAPD, adjusted for confounders, comorbid autism spectrum disorder (ASD) and substance abuse. ADHD cases were also compared to their unaffected full siblings. We analyzed 18,139 ADHD cases and 72,437 sex and birth year matched controls. NAPD was more common in cases than controls (2.7 and 0.4%, respectively). After adjustment for confounders, ADHD cases had markedly high risk for NAPD (OR: 6.99; 95% CI 6.03-8.10), which attenuated further after adjustment for ASD and substance abuse (OR: 2.57; 95% CI 2.09-3.16). Utilization of ADHD medication increased the risk for NAPD (ORs for change in odds of NAPD for every 5 extra prescriptions of stimulants 1.06 (95% CI 1.02-1.10) and, non-stimulants 1.15 (95% CI 1.01-1.30)). There was no association between usage length of medication and risk for NAPD. The risk was higher in individuals with ADHD than their unaffected siblings (OR: 2.95 (95% CI 2.07-4.20)). Overall, ADHD was associated with elevated risk for NAPD, which is not entirely explained by shared familial factors. The clinical severity leading to medical treatment may also increase NAPD risk. Ethics approval: Approved by the ethical committee in Stockholm, Sweden (dnrs: 2010-1185-31/5 and 2013/1118-32).

中文翻译:

注意缺陷/多动障碍和非情感性精神障碍的风险:ADHD 药物和合并症的作用,以及同胞比较

注意缺陷/多动障碍 (ADHD) 是儿童期最常见的精神障碍。目前尚不清楚 ADHD 是否会增加非情感性精神病 (NAPD) 的风险。该研究包括一个匹配的队列,从 1987-1991 年出生于瑞典的所有人中抽取(n = 548,852)。ADHD 被定义为 ICD 诊断和/或 ADHD 药物处方。我们区分了兴奋剂和非兴奋剂,以及使用时间(<1 年、1-2 年和≥2 年)。我们用 95% 置信区间 (CI) 计算了 NAPD 的比值比 (OR),调整了混杂因素、共病自闭症谱系障碍 (ASD) 和药物滥用。还将 ADHD 病例与其未受影响的全兄弟姐妹进行了比较。我们分析了 18,139 名 ADHD 病例和 72,437 名性别和出生年份匹配的对照。NAPD 在病例中比对照组更常见(分别为 2.7% 和 0.4%)。调整混杂因素后,ADHD 病例的 NAPD 风险显着升高(OR:6.99;95% CI 6.03-8.10),在调整 ASD 和药物滥用后进一步减弱(OR:2.57;95% CI 2.09-3.16)。使用 ADHD 药物会增加 NAPD 的风险(每 5 次额外服用兴奋剂处方的 NAPD 几率变化 OR 为 1.06(95% CI 1.02-1.10)和非兴奋剂 1.15(95% CI 1.01-1.30))。药物使用时间长短与 NAPD 风险之间没有关联。ADHD 患者的风险高于其未受影响的兄弟姐妹(OR:2.95(95% CI 2.07-4.20))。总体而言,ADHD 与 NAPD 风险升高有关,这并不能完全由共同的家族因素来解释。导致医疗的临床严重程度也可能增加 NAPD 风险。伦理批准:
更新日期:2020-04-01
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