伴并发性ADHD和PTSD的青少年的治疗模式和临床结果:从现实世界数据的洞察力
Raman Baweja1, Fabiana Lopes1, Felix M Padilla1
1Penn State College of Medicine, Hershey, PA, USA.
Journal of attention disorders
|February 12, 2026
概括
患有ADHD和PTSD的年轻人接受了更广泛的治疗,临床医生可能未充分利用兴奋剂. 兴奋剂对ADHD和PTSD的治疗结果更好,这凸显了需要基于证据的指导方针的需要.
科学领域:
- 儿童和青少年精神病学
- 神经发育障碍 神经发育障碍
- 创伤和心理健康问题
背景情况:
- 注意缺陷/多动症 (ADHD) 和创伤后应激障碍 (PTSD) 经常在年轻人中同时发生.
- 创伤后应激障碍对儿童群体ADHD治疗选择和结果的影响尚不清楚.
研究的目的:
- 调查患有ADHD的年轻人的处方模式和临床结果,比较患有并无并发性PTSD的年轻人.
- 分析PTSD诊断如何影响儿童ADHD病例的治疗选择和患者结果.
主要方法:
- 使用TriNetX研究网络的电子健康记录进行的回顾性队列研究.
- 对超过714,000名被诊断患有ADHD的年轻人 (6-18岁) 的分析,其中包括30341名伴随性PTSD患者.
- 倾向性得分匹配和调整的考克斯比例危险模型被用于评估治疗趋势和医疗保健利用等结果.
主要成果:
- 与单独患有ADHD的年轻人相比,患有ADHD和PTSD的年轻人接受了更多的非兴奋剂,抗抑郁药,抗精神病药,情绪稳定剂和心理治疗.
- 在患有PTSD的ADHD组中,甲基酸的处方略有降低,而安非他胺的使用保持稳定.
- 中枢神经系统 (CNS) 兴奋剂与优越的临床结果有关,包括减少住院和急诊,与非兴奋剂和抗抑郁药物相比,在患有多动症和创伤后应激障碍的青少年中.
结论:
- 患有ADHD和并发性PTSD的年轻人呈现复杂的临床特征,需要不同的治疗方法.
- 当前的临床实践可能会在PTSD存在时降低对ADHD的兴奋剂药物的优先级,尽管有证据支持它们的有效性.
- 迫切需要前性研究和基于证据的治疗指南,以优化对这种高风险儿科患者的护理.
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