The Association Between Attention-Deficit Hyperactivity Disorder, Injuries, and Methylphenidate
Objective . To evaluate the relationship between attention-deficit hyperactivity disorder (ADHD) and injuries and to verify whether methylphenidate (MPH), is associated with decreasing the risk of injuries. Methods . A retrospective cohort study using the computerized database of Maccabi Healthcare...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-05-01
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| Series: | Global Pediatric Health |
| Online Access: | https://doi.org/10.1177/2333794X19845920 |
| _version_ | 1831791624153202688 |
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| author | Sharon Shem-Tov BSc Gabriel Chodick PhD Dalia Weitzman PhD Gideon Koren MD |
| author_facet | Sharon Shem-Tov BSc Gabriel Chodick PhD Dalia Weitzman PhD Gideon Koren MD |
| author_sort | Sharon Shem-Tov BSc |
| collection | DOAJ |
| description | Objective . To evaluate the relationship between attention-deficit hyperactivity disorder (ADHD) and injuries and to verify whether methylphenidate (MPH), is associated with decreasing the risk of injuries. Methods . A retrospective cohort study using the computerized database of Maccabi Healthcare Services. The ADHD cohort included all children between 12 and 20 years of age, newly diagnosed with ADHD between 2003 and 2013. The comparison cohort was composed of children who were not diagnosed with ADHD. The primary outcome was traumatic injuries. A Cox proportional hazard regression analysis was conducted to estimate ADHD effects on the risk of injuries. We also conducted a nested case-control study to examine how MPH influences this relationship. Results . A total of 59 798 children were included in the cohort study; 28 921 were classified as exposed (ADHD cohort) and 30 877 were unexposed. The traumatic injuries incidence in the exposed group was significantly higher (adjusted hazard ratio = 1.63 [95% confidence interval = 1.60-1.66]). Similar increased risk was documented also for severe injuries (adjusted hazard ratio = 1.72 [1.59-1.86]). MPH use was significantly associated with 28% lower injury events. Therapy groups were significantly associated with 29% to 40% lower injuries rate for medium- or long-acting MPH. The intensity of therapy was significantly associated with 29% to 33% lower injury rate when the intensity was lower than 0.69 mg/kg/day. Conclusion . Children with ADHD have a 60% increased odds of experiencing an injury. Treatment with MPH reduced the risk by up to 28%. The individual and financial cost secondary to injuries, underscores the public health significance of this problem. Injury prevention should be considered in clinical evaluation of MPH risks and benefits, beyond the conventional consideration of enhancing academic achievements. |
| first_indexed | 2024-12-22T14:57:47Z |
| format | Article |
| id | doaj.art-7adc612ebc2f4fcd8b42799b654f82f2 |
| institution | Directory Open Access Journal |
| issn | 2333-794X |
| language | English |
| last_indexed | 2024-12-22T14:57:47Z |
| publishDate | 2019-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Global Pediatric Health |
| spelling | doaj.art-7adc612ebc2f4fcd8b42799b654f82f22022-12-21T18:22:12ZengSAGE PublishingGlobal Pediatric Health2333-794X2019-05-01610.1177/2333794X19845920The Association Between Attention-Deficit Hyperactivity Disorder, Injuries, and MethylphenidateSharon Shem-Tov BSc0Gabriel Chodick PhD1Dalia Weitzman PhD2Gideon Koren MD3Tel Aviv University, Tel Aviv, IsraelMaccabi Sherutei Briut, Tel Aviv, IsraelMaccabi Sherutei Briut, Tel Aviv, IsraelMaccabi Sherutei Briut, Tel Aviv, IsraelObjective . To evaluate the relationship between attention-deficit hyperactivity disorder (ADHD) and injuries and to verify whether methylphenidate (MPH), is associated with decreasing the risk of injuries. Methods . A retrospective cohort study using the computerized database of Maccabi Healthcare Services. The ADHD cohort included all children between 12 and 20 years of age, newly diagnosed with ADHD between 2003 and 2013. The comparison cohort was composed of children who were not diagnosed with ADHD. The primary outcome was traumatic injuries. A Cox proportional hazard regression analysis was conducted to estimate ADHD effects on the risk of injuries. We also conducted a nested case-control study to examine how MPH influences this relationship. Results . A total of 59 798 children were included in the cohort study; 28 921 were classified as exposed (ADHD cohort) and 30 877 were unexposed. The traumatic injuries incidence in the exposed group was significantly higher (adjusted hazard ratio = 1.63 [95% confidence interval = 1.60-1.66]). Similar increased risk was documented also for severe injuries (adjusted hazard ratio = 1.72 [1.59-1.86]). MPH use was significantly associated with 28% lower injury events. Therapy groups were significantly associated with 29% to 40% lower injuries rate for medium- or long-acting MPH. The intensity of therapy was significantly associated with 29% to 33% lower injury rate when the intensity was lower than 0.69 mg/kg/day. Conclusion . Children with ADHD have a 60% increased odds of experiencing an injury. Treatment with MPH reduced the risk by up to 28%. The individual and financial cost secondary to injuries, underscores the public health significance of this problem. Injury prevention should be considered in clinical evaluation of MPH risks and benefits, beyond the conventional consideration of enhancing academic achievements.https://doi.org/10.1177/2333794X19845920 |
| spellingShingle | Sharon Shem-Tov BSc Gabriel Chodick PhD Dalia Weitzman PhD Gideon Koren MD The Association Between Attention-Deficit Hyperactivity Disorder, Injuries, and Methylphenidate Global Pediatric Health |
| title | The Association Between Attention-Deficit Hyperactivity Disorder, Injuries, and Methylphenidate |
| title_full | The Association Between Attention-Deficit Hyperactivity Disorder, Injuries, and Methylphenidate |
| title_fullStr | The Association Between Attention-Deficit Hyperactivity Disorder, Injuries, and Methylphenidate |
| title_full_unstemmed | The Association Between Attention-Deficit Hyperactivity Disorder, Injuries, and Methylphenidate |
| title_short | The Association Between Attention-Deficit Hyperactivity Disorder, Injuries, and Methylphenidate |
| title_sort | association between attention deficit hyperactivity disorder injuries and methylphenidate |
| url | https://doi.org/10.1177/2333794X19845920 |
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