Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish prescribed drug register / Viktoria JOHANSSON in Journal of Neurodevelopmental Disorders, 12 (2020)  

Public ISBD [article]  inJournal of Neurodevelopmental Disorders > 12 (2020) Titre : Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish prescribed drug register Type de document : texte imprimé Auteurs : Viktoria JOHANSSON, Auteur ; Sven SANDIN, Auteur ; Zheng CHANG, Auteur ; Mark J. TAYLOR, Auteur ; Paul LICHTENSTEIN, Auteur ; Brian M. D'ONOFRIO, Auteur ; Henrik LARSSON, Auteur ; Clara HELLNER, Auteur ; Linda HALLDNER, Auteur Langues : Anglais (eng) Mots-clés : Adolescent  Adult  Aged  Aged, 80 and over  Attention Deficit Disorder with Hyperactivity/complications/drug  therapy/epidemiology  Autism Spectrum Disorder/complications/drug therapy/epidemiology  Child  Child, Preschool  Humans  Methylphenidate/therapeutic use  Middle Aged  Pharmaceutical Preparations  Sweden/epidemiology  Young Adult Index. décimale : PER Périodiques Résumé : BACKGROUND: Clinical studies found that medication for attention-deficit/hyperactivity disorder (ADHD) is effective in coexisting autism spectrum disorder (ASD), but current research is based on small clinical studies mainly performed on children or adolescents. We here use register data to examine if individuals with ADHD and coexisting ASD present differences in the prescribing patterns of ADHD medication when compared to individuals with pure ADHD. METHODS: Data with information on filled prescriptions and diagnoses was retrieved from the Swedish Prescribed Drug Register and the National Patient Register. We identified 34,374 individuals with pure ADHD and 5012 individuals with ADHD and coexisting ASD, aged between 3 and 80 years. The first treatment episode with ADHD medications (≥ 2 filled prescriptions within 90 days) and daily doses of methylphenidate during a 3-year period was measured. Odds ratios (ORs) were calculated for the likelihood of being prescribed ADHD medication in individuals with and without ASD and Wilcoxon rank-sum test was used to compare group differences in dose per day. RESULTS: Individuals with ADHD and coexisting ASD were less likely to start continuous treatment with ADHD medication (ADHD 80.5%; ADHD with ASD 76.2%; OR, 0.80; 95% confidence interval, 0.75-0.86), were less likely to be prescribed methylphenidate, and were more commonly prescribed second line treatments such as dexamphetamine, amphetamine, or modafinil. No group difference was observed for atomoxetine. In adults with ADHD and coexisting ASD, methylphenidate was prescribed in lower daily doses over three years as compared to individuals with pure ADHD. CONCLUSIONS: The findings indicate that there are differences in the medical treatment of individuals with or without ASD. If these differences are due to different medication responses in ASD or due to other factors such as clinicians' perceptions of medication effects in patients with ASD, needs to be further studied. En ligne : https://dx.doi.org/10.1186/s11689-020-09352-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=573 [article] Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish prescribed drug register [texte imprimé] / Viktoria JOHANSSON, Auteur ; Sven SANDIN, Auteur ; Zheng CHANG, Auteur ; Mark J. TAYLOR, Auteur ; Paul LICHTENSTEIN, Auteur ; Brian M. D'ONOFRIO, Auteur ; Henrik LARSSON, Auteur ; Clara HELLNER, Auteur ; Linda HALLDNER, Auteur. Langues : Anglais (eng) in Journal of Neurodevelopmental Disorders > 12 (2020) Mots-clés : Adolescent  Adult  Aged  Aged, 80 and over  Attention Deficit Disorder with Hyperactivity/complications/drug  therapy/epidemiology  Autism Spectrum Disorder/complications/drug therapy/epidemiology  Child  Child, Preschool  Humans  Methylphenidate/therapeutic use  Middle Aged  Pharmaceutical Preparations  Sweden/epidemiology  Young Adult Index. décimale : PER Périodiques Résumé : BACKGROUND: Clinical studies found that medication for attention-deficit/hyperactivity disorder (ADHD) is effective in coexisting autism spectrum disorder (ASD), but current research is based on small clinical studies mainly performed on children or adolescents. We here use register data to examine if individuals with ADHD and coexisting ASD present differences in the prescribing patterns of ADHD medication when compared to individuals with pure ADHD. METHODS: Data with information on filled prescriptions and diagnoses was retrieved from the Swedish Prescribed Drug Register and the National Patient Register. We identified 34,374 individuals with pure ADHD and 5012 individuals with ADHD and coexisting ASD, aged between 3 and 80 years. The first treatment episode with ADHD medications (≥ 2 filled prescriptions within 90 days) and daily doses of methylphenidate during a 3-year period was measured. Odds ratios (ORs) were calculated for the likelihood of being prescribed ADHD medication in individuals with and without ASD and Wilcoxon rank-sum test was used to compare group differences in dose per day. RESULTS: Individuals with ADHD and coexisting ASD were less likely to start continuous treatment with ADHD medication (ADHD 80.5%; ADHD with ASD 76.2%; OR, 0.80; 95% confidence interval, 0.75-0.86), were less likely to be prescribed methylphenidate, and were more commonly prescribed second line treatments such as dexamphetamine, amphetamine, or modafinil. No group difference was observed for atomoxetine. In adults with ADHD and coexisting ASD, methylphenidate was prescribed in lower daily doses over three years as compared to individuals with pure ADHD. CONCLUSIONS: The findings indicate that there are differences in the medical treatment of individuals with or without ASD. If these differences are due to different medication responses in ASD or due to other factors such as clinicians' perceptions of medication effects in patients with ASD, needs to be further studied. En ligne : https://dx.doi.org/10.1186/s11689-020-09352-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=573

Relative immaturity and ADHD: findings from nationwide registers, parent- and self-reports / Linda HALLDNER in Journal of Child Psychology and Psychiatry, 55-8 (August 2014)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 55-8 (August 2014) . - p.897-904 Titre : Relative immaturity and ADHD: findings from nationwide registers, parent- and self-reports Type de document : texte imprimé Auteurs : Linda HALLDNER, Auteur ; Annika TILLANDER, Auteur ; Cecilia LUNDHOLM, Auteur ; Marcus BOMAN, Auteur ; Niklas LANGSTROM, Auteur ; Henrik LARSSON, Auteur ; Paul LICHTENSTEIN, Auteur Article en page(s) : p.897-904 Langues : Anglais (eng) Mots-clés : ADHD  child development  pharmacotherapy  epidemiological studies Index. décimale : PER Périodiques Résumé : Background We addressed if immaturity relative to peers reflected in birth month increases the likelihood of ADHD diagnosis and treatment. Methods We linked nationwide Patient and Prescribed Drug Registers and used prospective cohort and nested case–control designs to study 6–69 year-old individuals in Sweden from July 2005 to December 2009 (Cohort 1). Cohort 1 included 56,263 individuals diagnosed with ADHD or ever used prescribed ADHD-specific medication. Complementary population-representative cohorts provided DSM-IV ADHD symptom ratings; parent-reported for 10,760 9-year-old twins born 1995–2000 from the CATSS study (Cohort 2) and self-reported for 6,970 adult twins age 20–47 years born 1959–1970 from the STAGE study (Cohort 3). We calculated odds ratios (OR:s) for ADHD across age for individuals born in November/December compared to January/February (Cohort 1). ADHD symptoms in Cohorts 2 and 3 were studied as a function of calendar birth month. Results ADHD diagnoses and medication treatment were both significantly more common in individuals born in November/December versus January/February; peaking at ages 6 (OR: 1.8; 95% CI: 1.5–2.2) and 7 years (OR: 1.6; 95% CI: 1.3–1.8) in the Patient and Prescribed Drug Registers, respectively. We found no corresponding differences in parent- or self-reported ADHD symptoms by calendar birth month. Conclusion Relative immaturity compared to class mates might contribute to ADHD diagnosis and pharmacotherapy despite absence of parallel findings in reported ADHD symptom loads by relative immaturity. Increased clinical awareness of this phenomenon may be warranted to decrease risk for imprecise diagnostics and treatment. We speculate that flexibility regarding age at school start according to individual maturity could reduce developmentally inappropriate demands on children and improve the precision of ADHD diagnostic practice and pharmacological treatment. En ligne : http://dx.doi.org/10.1111/jcpp.12229 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=237 [article] Relative immaturity and ADHD: findings from nationwide registers, parent- and self-reports [texte imprimé] / Linda HALLDNER, Auteur ; Annika TILLANDER, Auteur ; Cecilia LUNDHOLM, Auteur ; Marcus BOMAN, Auteur ; Niklas LANGSTROM, Auteur ; Henrik LARSSON, Auteur ; Paul LICHTENSTEIN, Auteur . - p.897-904. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 55-8 (August 2014) . - p.897-904 Mots-clés : ADHD  child development  pharmacotherapy  epidemiological studies Index. décimale : PER Périodiques Résumé : Background We addressed if immaturity relative to peers reflected in birth month increases the likelihood of ADHD diagnosis and treatment. Methods We linked nationwide Patient and Prescribed Drug Registers and used prospective cohort and nested case–control designs to study 6–69 year-old individuals in Sweden from July 2005 to December 2009 (Cohort 1). Cohort 1 included 56,263 individuals diagnosed with ADHD or ever used prescribed ADHD-specific medication. Complementary population-representative cohorts provided DSM-IV ADHD symptom ratings; parent-reported for 10,760 9-year-old twins born 1995–2000 from the CATSS study (Cohort 2) and self-reported for 6,970 adult twins age 20–47 years born 1959–1970 from the STAGE study (Cohort 3). We calculated odds ratios (OR:s) for ADHD across age for individuals born in November/December compared to January/February (Cohort 1). ADHD symptoms in Cohorts 2 and 3 were studied as a function of calendar birth month. Results ADHD diagnoses and medication treatment were both significantly more common in individuals born in November/December versus January/February; peaking at ages 6 (OR: 1.8; 95% CI: 1.5–2.2) and 7 years (OR: 1.6; 95% CI: 1.3–1.8) in the Patient and Prescribed Drug Registers, respectively. We found no corresponding differences in parent- or self-reported ADHD symptoms by calendar birth month. Conclusion Relative immaturity compared to class mates might contribute to ADHD diagnosis and pharmacotherapy despite absence of parallel findings in reported ADHD symptom loads by relative immaturity. Increased clinical awareness of this phenomenon may be warranted to decrease risk for imprecise diagnostics and treatment. We speculate that flexibility regarding age at school start according to individual maturity could reduce developmentally inappropriate demands on children and improve the precision of ADHD diagnostic practice and pharmacological treatment. En ligne : http://dx.doi.org/10.1111/jcpp.12229 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=237

Stimulant ADHD medication and risk for substance abuse / Zheng CHANG in Journal of Child Psychology and Psychiatry, 55-8 (August 2014)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 55-8 (August 2014) . - p.878-885 Titre : Stimulant ADHD medication and risk for substance abuse Type de document : texte imprimé Auteurs : Zheng CHANG, Auteur ; Paul LICHTENSTEIN, Auteur ; Linda HALLDNER, Auteur ; Brian M. D'ONOFRIO, Auteur ; Eva SERLACHIUS, Auteur ; Seena FAZEL, Auteur ; Niklas LANGSTROM, Auteur ; Henrik LARSSON, Auteur Article en page(s) : p.878-885 Langues : Anglais (eng) Mots-clés : ADHD  pharmacology  substance abuse Index. décimale : PER Périodiques Résumé : Background There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse. Methods Using Swedish national registers, we studied all individuals born between 1960 and 1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits. Results ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57–0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. Conclusions We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients. En ligne : http://dx.doi.org/10.1111/jcpp.12164 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=237 [article] Stimulant ADHD medication and risk for substance abuse [texte imprimé] / Zheng CHANG, Auteur ; Paul LICHTENSTEIN, Auteur ; Linda HALLDNER, Auteur ; Brian M. D'ONOFRIO, Auteur ; Eva SERLACHIUS, Auteur ; Seena FAZEL, Auteur ; Niklas LANGSTROM, Auteur ; Henrik LARSSON, Auteur . - p.878-885. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 55-8 (August 2014) . - p.878-885 Mots-clés : ADHD  pharmacology  substance abuse Index. décimale : PER Périodiques Résumé : Background There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse. Methods Using Swedish national registers, we studied all individuals born between 1960 and 1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits. Results ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57–0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. Conclusions We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients. En ligne : http://dx.doi.org/10.1111/jcpp.12164 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=237

The effect of autistic traits on response to and side-effects of pharmacological ADHD treatment in children with ADHD: results from a prospective clinical cohort / Maria M. LILJA in Journal of Neurodevelopmental Disorders, 14 (2022)  

Public ISBD [article]  inJournal of Neurodevelopmental Disorders > 14 (2022) Titre : The effect of autistic traits on response to and side-effects of pharmacological ADHD treatment in children with ADHD: results from a prospective clinical cohort Type de document : texte imprimé Auteurs : Maria M. LILJA, Auteur ; Emil SANDBLOM, Auteur ; Paul LICHTENSTEIN, Auteur ; Eva SERLACHIUS, Auteur ; Clara HELLNER, Auteur ; Jyoti BHAGIA, Auteur ; Linda HALLDNER, Auteur Langues : Anglais (eng) Mots-clés : Adolescent  Attention Deficit Disorder with Hyperactivity/complications/drug therapy  Autism Spectrum Disorder/complications/drug therapy  Autistic Disorder/complications  Central Nervous System Stimulants/adverse effects  Child  Humans  Prospective Studies  Adhd  Asd  Adverse event  Effect  Pharmacological treatment Index. décimale : PER Périodiques Résumé : BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a common childhood behavioral condition that globally affects an average of around 5% of children and is associated with several adverse life outcomes. Comorbidity with autism spectrum disorder (ASD) is highly prevalent. Pharmacological treatment for ADHD symptoms has been shown to be effective. However, the prevailing perception is that children with ADHD and concomitant ASD symptoms report poorer efficacy and more side effects. This has been supported by studies on this population, but prospective studies directly comparing children with ADHD and different levels of ASD symptoms are lacking. We aimed to assess if children with ADHD and concomitant ASD symptoms differ regarding effects and side-effects of pharmacological ADHD treatment compared to children with ADHD without ASD traits. This is to our knowledge the second study to directly compare the effect of ADHD medication between ADHD patients with different levels of ASD symptoms. METHODS: In a non-randomized, observational, prospective cohort study, 323 patients aged 6 to 17 years who were diagnosed with ADHD and starting pharmacological treatment were divided into two groups: one with high level of ASD symptoms (ASD group, N=71) and one with low level of ASD symptoms (non-ASD group, N = 252). Treatment outcome was measured as ADHD symptoms, and evaluated using the Swanson, Nolan and Pelham Teacher and Parent ADHD rating scale-version IV (SNAP-IV). Side-effects were evaluated using the Pediatric Side Effects Checklist (P-SEC), at 3 months follow-up. RESULTS: From baseline to 3 months, there was no significant difference in neither treatment effect nor number of clinically significant adverse events experienced between the ASD group and the non-ASD group. CONCLUSIONS: Our results did not implicate that ADHD patients with concomitant ASD symptoms have decreased treatment effect of ADHD medication than patients with ADHD without concomitant ASD symptoms. Neither did the results support that ADHD patients with ASD symptoms experienced significantly more side-effects than ADHD patients without ASD symptoms. Although, we did not analyze different medications separately, this is in line with the only previous study directly comparing methylphenidate treatment in children with or without ASD. TRIAL REGISTRATION: NCT02136147 , May 12, 2014. En ligne : https://dx.doi.org/10.1186/s11689-022-09424-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=574 [article] The effect of autistic traits on response to and side-effects of pharmacological ADHD treatment in children with ADHD: results from a prospective clinical cohort [texte imprimé] / Maria M. LILJA, Auteur ; Emil SANDBLOM, Auteur ; Paul LICHTENSTEIN, Auteur ; Eva SERLACHIUS, Auteur ; Clara HELLNER, Auteur ; Jyoti BHAGIA, Auteur ; Linda HALLDNER, Auteur. Langues : Anglais (eng) in Journal of Neurodevelopmental Disorders > 14 (2022) Mots-clés : Adolescent  Attention Deficit Disorder with Hyperactivity/complications/drug therapy  Autism Spectrum Disorder/complications/drug therapy  Autistic Disorder/complications  Central Nervous System Stimulants/adverse effects  Child  Humans  Prospective Studies  Adhd  Asd  Adverse event  Effect  Pharmacological treatment Index. décimale : PER Périodiques Résumé : BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a common childhood behavioral condition that globally affects an average of around 5% of children and is associated with several adverse life outcomes. Comorbidity with autism spectrum disorder (ASD) is highly prevalent. Pharmacological treatment for ADHD symptoms has been shown to be effective. However, the prevailing perception is that children with ADHD and concomitant ASD symptoms report poorer efficacy and more side effects. This has been supported by studies on this population, but prospective studies directly comparing children with ADHD and different levels of ASD symptoms are lacking. We aimed to assess if children with ADHD and concomitant ASD symptoms differ regarding effects and side-effects of pharmacological ADHD treatment compared to children with ADHD without ASD traits. This is to our knowledge the second study to directly compare the effect of ADHD medication between ADHD patients with different levels of ASD symptoms. METHODS: In a non-randomized, observational, prospective cohort study, 323 patients aged 6 to 17 years who were diagnosed with ADHD and starting pharmacological treatment were divided into two groups: one with high level of ASD symptoms (ASD group, N=71) and one with low level of ASD symptoms (non-ASD group, N = 252). Treatment outcome was measured as ADHD symptoms, and evaluated using the Swanson, Nolan and Pelham Teacher and Parent ADHD rating scale-version IV (SNAP-IV). Side-effects were evaluated using the Pediatric Side Effects Checklist (P-SEC), at 3 months follow-up. RESULTS: From baseline to 3 months, there was no significant difference in neither treatment effect nor number of clinically significant adverse events experienced between the ASD group and the non-ASD group. CONCLUSIONS: Our results did not implicate that ADHD patients with concomitant ASD symptoms have decreased treatment effect of ADHD medication than patients with ADHD without concomitant ASD symptoms. Neither did the results support that ADHD patients with ASD symptoms experienced significantly more side-effects than ADHD patients without ASD symptoms. Although, we did not analyze different medications separately, this is in line with the only previous study directly comparing methylphenidate treatment in children with or without ASD. TRIAL REGISTRATION: NCT02136147 , May 12, 2014. En ligne : https://dx.doi.org/10.1186/s11689-022-09424-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=574

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