兴奋剂治疗和物质使用之间的关联通过青春期进入早期成年期
Brooke S G Molina1, Traci M Kennedy2, Andrea L Howard3
1Departments of Psychiatry, Psychology, & Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania.
JAMA psychiatry
|July 5, 2023
概括
在一项长期研究中,对注意力缺陷/多动障碍 (ADHD) 的兴奋剂治疗与以后的物质使用没有关联. 这一发现适用于各种物质和治疗持续时间,为一项备受辩论的临床问题提供了清晰度.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 对注意力缺陷/多动障碍 (ADHD) 的兴奋剂药物治疗和随后的物质使用之间的关系是一个重要的临床问题.
- 之前的研究产生了相互矛盾的结果,需要使用强大的方法进行进一步的研究.
研究的目的:
- 调查ADHD的兴奋剂治疗与成年期发展物质使用障碍的风险之间的关联.
- 在评估这种关系时解决方法学复杂性,包括动态混变量.
主要方法:
- 利用了ADHD多模式治疗研究 (MTA) 的数据,这是一项纵向观察性研究.
- 分析了579名被诊断患有多动症的儿童的数据,从童年 (年龄7-9岁) 到年轻成人 (平均年龄25岁) 进行了跟踪.
- 采用通用的多层线性模型和边缘结构模型来解释混因素和发展趋势.
主要成果:
- 没有证据表明当前或之前的兴奋剂治疗与增加或减少物质使用有关.
- 较长的持续时间或持续的兴奋剂治疗与较高的成年物质使用率无关.
- 即使调整了人口统计学,临床,家庭因素和相反的年龄相关趋势,结果仍然是一致的.
结论:
- 儿童ADHD的兴奋剂治疗与青春期和年轻成年期后期物质使用的风险增加无关.
- 这些发现在物质使用风险的背景下,为刺激药物的安全性提供了保证.
- 该研究的严格方法加强了ADHD治疗指南的证据基础.
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