Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:84

Review

Ruiz-Goikoetxea, Maite¹  Cortese, Samuele^2,3,4  Aznarez-Sanado, Maite⁵  Magallon, Sara⁵  Alvarez Zallo, Noelia¹  Luis, Elkin O.⁵  de Castro-Manglano, Pilar⁶  Soutullo, Cesar⁶  Arrondo, Gonzalo⁷ 

[1] Serv Navarro Salud Osasunbidea, Serv Urgencias Extrahosp, Pamplona, Spain

[2] Univ Southampton, Acad Unit Psychol, Ctr Innovat Mental Hlth, Southampton, Hants, England

[3] Univ Southampton, Fac Med Clin & Expt Sci CNS & Psychiat, Southampton, Hants, England

[4] NYU, Langone Med Ctr, Dept Child & Adolescent Psychiat, New York, NY USA

[5] Univ Navarra, Fac Educ & Psicol, Pamplona, Spain

[6] Clin Univ Navarra, Unidad Psiquiatria Infantil & Adolescente, Dept Psiquiatria & Psicol Med, Pamplona, Spain

[7] Univ Navarra, ICS, Grp Mente Cerebro, Pamplona, Spain

关键词: ADHD;    Unintentional physical injuries;    Stimulants;    Epidemiology;    Robust variance estimation;    Public health;    Pediatrics;    Child psychiatry;   

DOI  :  10.1016/j.neubiorev.2017.11.007

来源: Elsevier

【 摘 要 】

A systematic review with meta-analyses was performed to: 1) quantify the association between ADHD and risk of unintentional physical injuries in children/adolescents (risk analysis); 2) assess the effect of ADHD medications on this risk (medication analysis). We searched 114 databases through June 2017. For the risk analysis, studies reporting sex-controlled odds ratios (ORs) or hazard ratios (HRs) estimating the association between ADHD and injuries were combined. Pooled ORs (28 studies, 4,055,620 individuals without and 350,938 with ADHD) and HRs (4 studies, 901,891 individuals without and 20,363 with ADHD) were 1.53 (95% CI = 1.40,1.67) and 1.39 (95% CI = 1.06,1.83), respectively. For the medication analysis, we meta-analysed studies that avoided the confounding-by-indication bias [four studies with a self-controlled methodology and another comparing risk over time and groups (a difference in differences methodology)]. The pooled effect size was 0.879 (95% CI = 0.838,0.922) (13,254 individuals with ADHD). ADHD is significantly associated with an increased risk of unintentional injuries and ADHD medications have a protective effect, at least in the short term, as indicated by self-controlled studies.

【 授权许可】

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