Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: a systematic review and meta-analysis
Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: a systematic review and meta-analysis
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.
ADHD, Child psychiatry, Epidemiology, Pediatrics, Public health, Robust variance estimation, Stimulants, Unintentional physical injuries
63-71
Ruiz-Goikoetxea, Maite
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Cortese, Samuele
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Aznarez-Sanado, Maite
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Magallón, Sara
ada1177a-75d3-4ceb-8d2b-48fa0703033b
Alvarez Zallo, Noelia
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Luis, Elkin O.
aa0b559d-ff4d-4d30-97b6-c2af3eb6485a
de Castro-Manglano, Pilar
e5b77ce0-eb03-4cd3-af49-066b31145abd
Soutullo, Cesar
427da6c4-a6b9-4349-9de4-517c59750270
Arrondo, Gonzalo
5b9c1446-74f9-4dc7-aa73-6c67f3eaddbc
1 January 2018
Ruiz-Goikoetxea, Maite
e751449f-8f23-4c6c-8a91-48383398f7de
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Aznarez-Sanado, Maite
84eca809-fc6e-4733-9731-1b34190bfbcd
Magallón, Sara
ada1177a-75d3-4ceb-8d2b-48fa0703033b
Alvarez Zallo, Noelia
d2cc6fb2-b241-4af1-bebb-0bef573548a9
Luis, Elkin O.
aa0b559d-ff4d-4d30-97b6-c2af3eb6485a
de Castro-Manglano, Pilar
e5b77ce0-eb03-4cd3-af49-066b31145abd
Soutullo, Cesar
427da6c4-a6b9-4349-9de4-517c59750270
Arrondo, Gonzalo
5b9c1446-74f9-4dc7-aa73-6c67f3eaddbc
Ruiz-Goikoetxea, Maite, Cortese, Samuele, Aznarez-Sanado, Maite, Magallón, Sara, Alvarez Zallo, Noelia, Luis, Elkin O., de Castro-Manglano, Pilar, Soutullo, Cesar and Arrondo, Gonzalo
(2018)
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, 84, .
(doi:10.1016/j.neubiorev.2017.11.007).
Abstract
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.
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Accepted/In Press date: 14 November 2017
e-pub ahead of print date: 21 November 2017
Published date: 1 January 2018
Keywords:
ADHD, Child psychiatry, Epidemiology, Pediatrics, Public health, Robust variance estimation, Stimulants, Unintentional physical injuries
Identifiers
Local EPrints ID: 417430
URI: http://eprints.soton.ac.uk/id/eprint/417430
ISSN: 0149-7634
PURE UUID: c2272718-3e6e-45da-b0c9-8c5ba42a80e8
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Date deposited: 31 Jan 2018 17:30
Last modified: 16 Mar 2024 04:21
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Contributors
Author:
Maite Ruiz-Goikoetxea
Author:
Maite Aznarez-Sanado
Author:
Sara Magallón
Author:
Noelia Alvarez Zallo
Author:
Elkin O. Luis
Author:
Pilar de Castro-Manglano
Author:
Cesar Soutullo
Author:
Gonzalo Arrondo
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