■长期使用药物是注意力缺陷/多动症(ADHD)的推荐治疗方法,然而,停药是常见的。对可能影响启动和停药的非医学因素进行了充分研究。因此,我们调查了不同的社会人口统计学因素和合并症与青少年开始和停止使用ADHD药物相关.
■我们使用单独关联的行政登记数据进行了一项基于人群的前瞻性队列研究。其中我们包括居住在瑞典的所有个人,在2006年1月至2016年12月期间首次诊断为ADHD的19至29岁之间(n=59224)。ADHD药物开始被定义为在队列进入日期之前3个月至之后6个月期间ADHD药物的第一个处方。那些开始多动症药物治疗的人被随访药物使用,直到停止,死亡/移民,或直到2019年。Logistic和Cox回归模型用于调查社会人口统计学之间的关联,与健康相关的预测因子和启动,以及中止。总的来说,41399人中有48.7%的人开始服用ADHD药物,最常见的是哌醋甲酯(87%)。在发起人中,15462(77%)在随访期间停止药物使用(中位时间:150天)。在相互调整所有其他预测因子之后,开始与年龄呈正相关,男性,更高的教育水平,与父母一起生活在家里有负面影响,移民身份,在被列入名单前一年失业,领取残疾抚恤金,患有自闭症,物质使用,精神分裂症谱系障碍,其他精神残疾/发育障碍,心血管疾病或以前的事故。中止与在国外出生呈正相关,生活在大城市,在被列入名单前一年失业,得了癌症,与更高的教育水平负相关,有抑郁症,焦虑或压力相关障碍,自闭症谱系障碍或糖尿病。
■除了医疗因素,社会人口统计学,在新诊断为ADHD的年轻成年人中,如教育程度和移民身份也可能在开始和停止使用ADHD药物方面发挥作用.
UNASSIGNED: Long-term medication use is a recommended treatment for attention-deficit/hyperactivity disorder (ADHD), however, discontinuation is common. Non-medical factors which might influence initiation and discontinuation are understudied. Therefore, we investigated how different sociodemographic factors and comorbidities were associated with the initiation and discontinuation of ADHD medication use among young adults.
UNASSIGNED: We conducted a population-based prospective cohort study using individually linked administrative register data, in which we included all individuals residing in Sweden, between the age of 19 and 29 who were first diagnosed with ADHD between January 2006 and December 2016 (n = 59224). ADHD medication initiation was defined as the first prescription of ADHD medication in the period from 3 months before to 6 months after the cohort entry date. Those who initiated ADHD medication were followed up for medication use until discontinuation, death/emigration, or until 2019. Logistic and Cox regression models were used to investigate the associations between sociodemographics, health-related predictors and initiation, as well as discontinuation. Overall, 48.7% of the 41399 individuals initiated ADHD medication, most often methylphenidate (87%). Among the initiators, 15462 (77%) discontinued medication use during the follow-up (median time: 150 days). After mutually adjusting all other predictors, initiation was positively associated with older age, male sex, higher level of education, and negatively associated with living at home with parents, immigrant status, being unemployed during the year before inclusion, being on disability pension, having autism, substance use, schizophrenia-spectrum disorders, other mental disability/developmental disorders, cardiovascular diseases or previous accidents. Discontinuation was positively associated with being born abroad, living in big cities, being unemployed during the year before inclusion, having cancer, and negatively associated with a higher educational level, having depression, anxiety or stress-related disorder, autism spectrum disorder or diabetes.
UNASSIGNED: Besides medical factors, sociodemographics, such as educational attainment and immigrant status might also play a role in the initiation and discontinuation of ADHD medication use among young adults newly diagnosed with ADHD.