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Pharmacopsychiatry 2016; 49(02): 45-50
DOI: 10.1055/s-0035-1565132
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Risk of Injury According to Attention Deficit Hyperactivity Disorder, Comorbid Mental Illness, and Medication Therapy

R. M. Merrill
1   Brigham Young University, Provo, USA
,
S. M. Thygerson
1   Brigham Young University, Provo, USA
,
C. A. Palmer
1   Brigham Young University, Provo, USA
› Author Affiliations
Further Information

Publication History

received 05 April 2015
revised 02 September 2015

accepted 05 October 2015

Publication Date:
01 February 2016 (online)

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Abstract

Introduction: We identify the risk of selected types of injuries among patients with ADHD or ADHD and comorbid mental illness. We also assess whether selected medications used by patients with ADHD increase the risk of comorbid mental illness or influence the association between ADHD and injury.

Methods: A retrospective cohort study design was conducted using medical claims data from the Deseret Mutual Benefit Administrators (DMBA). ADHD diagnosis, injury, medication, and demographic data were extracted from claims files during 2001–2013. Rate ratios were adjusted for age, sex, and calendar year.

Results: Patients with ADHD were 7.9 (95% CI 7.6–8.2) times more likely to have psychosis, 5.5 (3.9–7.8) times more likely to have alcohol- or drug-induced psychosis, and 6.0 (5.9–6.2) times more likely to have neurotic or personality disorder. Therapy with amphetamine was positively associated with neurotic or personality disorder (rate ratio=1.08, 1.02–1.15); methylphenidate was negatively associated with neurotic or personality disorder (0.90, 0.84–0.97); and atomoxetine was positively associated with psychosis (1.33, 1.21–1.46), alcohol- or drug-induced psychosis (2.38, 1.04–5.43), and neurotic or personality disorder (2.38, 1.04–5.43). ADHD was associated with an increased risk of injury, with ADHD and comorbid mental illness having a stronger increased risk of injury. Psychostimulants ameliorated the increased risk of injury for patients with ADHD.

Conclusion: Patients with ADHD have an increased risk of injury, significantly more so for those with ADHD and comorbid mental illness. Psychostimulants can lower the risk of injury among patients with ADHD.

Key words

ADHD - claims data - incidence - injury - retrospective cohort - risk
 

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