Methylphenidate and mortality in children with attention-deficit hyperactivity disorder: population-based cohort
Vincent Chin-Hung Chen1, Hsiang-Lin Chan2, Shu-I Wu3
1Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi; and Department of Psychiatry, Chang Gung University, Taoyuan, Taiwan.
Methylphenidate (MPH) use in children with attention-deficit hyperactivity disorder (ADHD) is linked to lower mortality. Longer MPH use correlated with reduced mortality, while delayed use showed increased risk.
Area of Science:
- Pediatric pharmacology
- Neurodevelopmental disorders
- Public health research
Background:
- Limited data exists on methylphenidate (MPH) use and its impact on mortality outcomes.
- Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
Purpose of the Study:
- To examine the association between MPH use and mortality in children diagnosed with ADHD.
- Investigate the relationship between MPH treatment duration and mortality risk.
Main Methods:
- Population-based cohort study utilizing Taiwan's National Health Insurance Research Database (NHIRD).
- Compared 68,096 children with ADHD and MPH prescription to 68,096 matched controls without MPH.
- Analyzed all-cause, unnatural-cause, and natural-cause mortality using time-dependent Cox regression.
Main Results:
- MPH use was associated with significantly lower all-cause mortality (AHR=0.81).
- Delayed MPH initiation was linked to higher mortality (AHR=1.05).
- Longer duration of MPH use correlated with reduced mortality (AHR=0.83).
Conclusions:
- Methylphenidate use appears to be associated with reduced overall mortality in children with ADHD.
- Unmeasured confounding factors cannot be entirely ruled out as a limitation.
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