兴奋剂和非兴奋剂ADHD药物与青少年和成人自杀之间的关系：一项基于人群的巢式病例对照研究。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research Pub Date : 2025-02-01 DOI:10.1016/j.psychres.2024.116309

Helen-Maria Vasiliadis , Louis Rochette , Victoria Massamba , Alain Lesage , Elham Rahme , Martin Gignac , Fatoumata Binta Diallo , Alvine Fansi , Samuele Cortese , Carlotta Lunghi

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引用次数: 0

摘要

导读：ADHD与自杀风险增加有关。本研究的目的是评估ADHD药物使用与自杀之间的关系。方法：这项巢式病例对照研究包括加拿大魁北克12-49岁的个体，诊断为ADHD和/或分配了ADHD药物。2000年至2021年间的自杀病例（n = 472）与5名对照（n = 2360）进行匹配，对照包括出生日期、性别和自杀死亡前至少365天（索引日期）持续的公共药物保险。使用多变量条件逻辑回归来估计ADHD药物使用与自杀之间的关系。还评估了特定ADHD药物类型与自杀之间的关系。结果：在控制了潜在的混杂因素后，在整个样本中，在12-24岁和25 - 49岁的个体中，以及之前有ADHD医生诊断的个体中，没有发现ADHD药物使用与完成自杀之间的显著关联。当只比较非兴奋剂的使用时，没有发现显著差异(aOR 1.27；95% CI: 0.62, 2.63)，兴奋剂和非兴奋剂(aOR 1.01；95% CI: 0.33, 3.08)，以及无药物治疗的ADHD咨询(aOR 0.94；95% CI: 0.69, 1.28)。结论：兴奋剂和非兴奋剂均与自杀风险无关。这些发现可以为临床决策提供参考。

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Association between stimulant and non-stimulant ADHD medications and completed suicide in adolescents and adults: A population-based nested case-control study

Introduction

ADHD has been linked to an increased risk of completed suicide. The aim of this study was to assess the relationship between ADHD medication use and completed suicide.

Methods

This nested case-control study included individuals aged 12–49 in Quebec, Canada, diagnosed with ADHD and/or dispensed ADHD medication. Suicide cases (n = 472) between 2000 and 2021 were matched with 5 controls each (n = 2360) on date of birth, sex, and continuous public drug insurance coverage for at least 365 days before suicide death (index date). Multivariable conditional logistic regression was used to estimate the association between ADHD medication use and completed suicide. The association between specific ADHD medication types and completed suicide was also assessed.

Results

After controlling for potential confounders, no significant association was found between ADHD medication use and completed suicide in the overall sample, in individuals aged 12–24 and 25 to 49 years, and those with a prior ADHD physician diagnosis. No significant differences were found when comparing the use of non-stimulants only (aOR 1.27; 95 % CI: 0.62, 2.63), stimulants and non-stimulants (aOR 1.01; 95 % CI: 0.33, 3.08), and ADHD consultation without medication (aOR 0.94; 95 % CI: 0.69, 1.28) against stimulant-only use.

Conclusion

Both stimulants and non-stimulants were not associated with the risk of completed suicide. These findings can inform clinical decision-making.

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来源期刊

Psychiatry Research 医学-精神病学

CiteScore

17.40

自引率

1.80%

发文量

527

审稿时长

57 days

期刊介绍： Psychiatry Research offers swift publication of comprehensive research reports and reviews within the field of psychiatry. The scope of the journal encompasses: Biochemical, physiological, neuroanatomic, genetic, neurocognitive, and psychosocial determinants of psychiatric disorders. Diagnostic assessments of psychiatric disorders. Evaluations that pursue hypotheses about the cause or causes of psychiatric diseases. Evaluations of pharmacologic and non-pharmacologic psychiatric treatments. Basic neuroscience studies related to animal or neurochemical models for psychiatric disorders. Methodological advances, such as instrumentation, clinical scales, and assays directly applicable to psychiatric research.