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Akmatov MK, Ermakova T, Bätzing J. Psychiatric and Nonpsychiatric Comorbidities Among Children With ADHD: An Exploratory Analysis of Nationwide Claims Data in Germany. J Atten Disord 2021; 25:874-884. [PMID: 31364481 DOI: 10.1177/1087054719865779] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: This study examined the full spectrum of comorbid disorders in all statutory-health-insured children aged 5 to 14 years with ADHD in 2017 by using nationwide claims data in Germany. Method: Children with ADHD (n = 258,662) were compared for the presence of 864 comorbid diseases with a control group matched by gender, age, and region of residence (n = 2,327,958). Results: Among others, metabolic disorders (odds ratio [OR] = 9.18; 95% confidence interval [CI] = [8.43, 9.99]), viral pneumonia (OR = 4.95; 95% CI = [2.37, 10.33]), disorders of white blood cells (OR = 4.55; 95% CI = [3.83, 5.40]), kidney failure (OR = 3.33; 95% CI = [2.65, 4.18]), hypertension (OR = 3.26; 95% CI = [3.00, 3.55]), obesity (OR = 2.85; 95% CI = [2.80, 2.91]), type 2 diabetes (OR = 2.61; 95% CI = [2.11, 3.23]), migraine (OR = 2.49; 95% CI = [2.37, 2.61]), asthma (OR = 2.19; 95% CI = [2.16, 2.22]), atopic dermatitis (OR = 2.10; 95% CI = [2.16, 2.23]), juvenile arthritis (OR = 1.56; 95% CI = [1.39, 1.76]), glaucoma (OR = 1.51; 95% CI = [1.30, 1.75]), and type 1 diabetes (OR = 1.30; 95% CI = [1.20, 1.40]) were more likely to be diagnosed in ADHD children. Conclusion: Along with psychiatric diseases, various somatic diseases were more common in ADHD children. The results have direct implications for patient care, including fine-grained diagnostics and personalized therapy.
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Affiliation(s)
- Manas K Akmatov
- Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - Tatiana Ermakova
- Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - Jörg Bätzing
- Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
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Hu JM, Lee CC, Lin TC, Chung CH, Chen CY, Chang PK, Hsiao CW, Sun CA, Tzeng NS, Chien WC. Risk of Colorectal Cancer in Patients With Attention-Deficit Hyperactivity Disorder: A Nationwide, Population-Based Cohort Study. Front Psychiatry 2021; 12:537137. [PMID: 33613335 PMCID: PMC7892783 DOI: 10.3389/fpsyt.2021.537137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 01/11/2021] [Indexed: 11/23/2022] Open
Abstract
Background: The association between attention-deficit hypersensitivity disorder (ADHD) and the risk of developing colorectal cancer (CRC) is, as yet, to be investigated, and thus, we have conducted this nationwide, cohort study to examine the association in patients from Taiwan. Methods: In this study, 798 individuals with newly diagnosed ADHD and 2,394 (1:3) age-, gender-, and index year- matched controls without ADHD were enrolled, between 2000 and 2013, from the Longitudinal Health Insurance Database, a subset of the National Health Insurance Research Database in Taiwan. The cumulative incidence of CRC was assessed in each cohort by the Kaplan-Meier method. The multivariate Cox proportional hazards model was used to estimate the crude, and the adjusted hazards ratios (HRs) with 95% confidence intervals (CIs), was conducted to estimate the association between ADHD and CRC. Results: The Kaplan-Meier analysis revealed that the cumulative incidence of CRC was significantly higher in patients with ADHD than in those without it (log rank test, p < 0.001). After adjustments for age, gender, comorbidities, and other covariates, the ADHD group was associated with an increased risk of CRC in comparison to the non-ADHD group (adjusted HR = 3.458, 95% CI = 1.640-7.293, p < 0.001). In addition, the usage of methylphenidate was not associated with the risk of developing CRC in patients with ADHD. Conclusion: This retrospective cohort study depicts the evidence that ADHD was associated with the increased risk of CRC. Further studies are needed to confirm the association and the underlying mechanisms.
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Affiliation(s)
- Je-Ming Hu
- Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.,Medical Informatics Office, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Cheng Lee
- Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Medical Informatics Office, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Artificial Intelligence Center, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tzu-Chiao Lin
- Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Chao-Yang Chen
- Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Pi-Kai Chang
- Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Cheng-Wen Hsiao
- Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chien-An Sun
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.,Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
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Solmi M, Fornaro M, Ostinelli EG, Zangani C, Croatto G, Monaco F, Krinitski D, Fusar‐Poli P, Correll CU. Safety of 80 antidepressants, antipsychotics, anti-attention-deficit/hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders: a large scale systematic meta-review of 78 adverse effects. World Psychiatry 2020; 19:214-232. [PMID: 32394557 PMCID: PMC7215080 DOI: 10.1002/wps.20765] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Mental disorders frequently begin in childhood or adolescence. Psychotropic medications have various indications for the treatment of mental dis-orders in this age group and are used not infrequently off-label. However, the adverse effects of these medications require special attention during developmentally sensitive periods of life. For this meta-review, we systematically searched network meta-analyses and meta-analyses of randomized controlled trials (RCTs), individual RCTs, and cohort studies reporting on 78 a priori selected adverse events across 19 categories of 80 psychotropic medications - including antidepressants, antipsychotics, anti-attention-deficit/hyperactivity disorder (ADHD) medications and mood stabilizers - in children and adolescents with mental disorders. We included data from nine network meta-analyses, 39 meta-analyses, 90 individual RCTs, and eight cohort studies, including 337,686 children and adolescents. Data on ≥20% of the 78 adverse events were available for six antidepressants (sertraline, escitalopram, paroxetine, fluoxetine, venlafaxine and vilazodone), eight antipsychotics (risperidone, quetiapine, aripiprazole, lurasidone, paliperidone, ziprasidone, olanzapine and asenapine), three anti-ADHD medications (methylphenidate, atomoxetine and guanfacine), and two mood stabilizers (valproate and lithium). Among these medications with data on ≥20% of the 78 adverse events, a safer profile emerged for escitalopram and fluoxetine among antidepressants, lurasidone for antipsychotics, methylphenidate among anti-ADHD medications, and lithium among mood stabilizers. The available literature raised most concerns about the safety of venlafaxine, olanzapine, atomoxetine, guanfacine and valproate. Nausea/vomiting and discontinuation due to adverse event were most frequently associated with antidepressants; sedation, extrapyramidal side effects, and weight gain with antipsychotics; anorexia and insomnia with anti-ADHD medications; sedation and weight gain with mood stabilizers. The results of this comprehensive and updated quantitative systematic meta-review of top-tier evidence regarding the safety of antidepressants, antipsychotics, anti-ADHD medications and mood stabilizers in children and adolescents can inform clinical practice, research and treatment guidelines.
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Affiliation(s)
- Marco Solmi
- Neurosciences DepartmentUniversity of PaduaPaduaItaly,Padua Neuroscience CenterUniversity of PaduaPaduaItaly,Early Psychosis: Interventions and Clinical‐detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | | | - Edoardo G. Ostinelli
- Oxford Health NHS Foundation TrustWarneford Hospital, and Department of Psychiatry, University of OxfordOxfordUK,Department of Health SciencesUniversity of MilanMilanItaly
| | | | | | | | | | - Paolo Fusar‐Poli
- Early Psychosis: Interventions and Clinical‐detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,OASIS ServiceSouth London & Maudsley NHS Foundation TrustLondonUK,Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly,National Institute for Health Research, Maudsley Biomedical Research CentreSouth London & Maudsley NHS Foundation TrustLondonUK
| | - Christoph U. Correll
- Department of Psychiatry, Zucker Hillside HospitalNorthwell HealthGlen OaksNew YorkNYUSA,Department of Psychiatry and Molecular MedicineZucker School of Medicine at Hofstra/NorthwellHempsteadNYUSA,Center for Psychiatric NeuroscienceFeinstein Institute for Medical ResearchManhassetNYUSA,Department of Child and Adolescent PsychiatryCharité Universitätsmedizin BerlinBerlinGermany
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Mohr-Jensen C, Vinkel Koch S, Briciet Lauritsen M, Steinhausen HC. The validity and reliability of the diagnosis of hyperkinetic disorders in the Danish Psychiatric Central Research Registry. Eur Psychiatry 2016; 35:16-24. [PMID: 27061373 DOI: 10.1016/j.eurpsy.2016.01.2427] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/29/2016] [Accepted: 01/30/2016] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To validate the diagnosis of hyperkinetic disorders (HD) in the Danish Psychiatric Central Research Registry (DPCRR) for children and adolescents aged 4 to 15 given in the years 1995 to 2005. METHOD From a total of 4568 participants, a representative random subsample of n=387 patients were used to validate the diagnosis. Patient files were systematically scored for the presence of ICD-10 criteria for HD and oppositional defiant disorder/conduct disorder (ODD/CD; F91). Further to this, an inter-rater reliability study was also conducted, whereby two experienced child and adolescent psychiatrists who were blind to patients discharge diagnoses, rated a random subsample of n=101 participants. RESULTS Information was available for 372 out of 387 patients. Out of n=372 available files, n=324 (86.8%) were evaluated to fulfil diagnostic criteria for HD. Due to missing information it was not possible to reach a conclusion for 5.1% of the cases, 3.8% of the diagnoses were registration errors, and in 4.3% of the files the diagnosis had to be rejected. Inter-rater agreement was high (κ=0.83, z=10.9, P<.001). The validity of hyperkinetic disorders, unspecified (F90.9) was lower and comorbid CD/ODD were under-diagnosed in the sample. All participants fulfilling HD criteria also fulfilled DSM-5-criteria for ADHD. CONCLUSION The risk of misclassification of patients with HD in the DPCRR is relatively low, with the exception of the diagnosis of hyperkinetic disorders, unspecified (F90.9).
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Affiliation(s)
- C Mohr-Jensen
- Research Unit of Child and Adolescent Psychiatry, Aalborg Psychiatric Hospital, Aalborg University Hospital, Aalborg, Denmark.
| | - S Vinkel Koch
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M Briciet Lauritsen
- Research Unit of Child and Adolescent Psychiatry, Aalborg Psychiatric Hospital, Aalborg University Hospital, Aalborg, Denmark
| | - H-C Steinhausen
- Research Unit of Child and Adolescent Psychiatry, Aalborg Psychiatric Hospital, Aalborg University Hospital, Aalborg, Denmark; Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland; Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
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