Quantifying the Protective Effects of Stimulants on Functional Outcomes in Attention-Deficit/Hyperactivity Disorder: A Focus on Number Needed to Treat Statistic and Sex Effects.
Adolescent
Attention Deficit Disorder with Hyperactivity
/ drug therapy
Automobile Driver Examination
/ statistics & numerical data
Case-Control Studies
Central Nervous System Stimulants
/ therapeutic use
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Lisdexamfetamine Dimesylate
/ therapeutic use
Male
Prospective Studies
Randomized Controlled Trials as Topic
Sex Factors
ADHD
Functional outcomes
Gender
Protective effects
Stimulants
Youth
Journal
The Journal of adolescent health : official publication of the Society for Adolescent Medicine
ISSN: 1879-1972
Titre abrégé: J Adolesc Health
Pays: United States
ID NLM: 9102136
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
22
01
2019
revised:
23
05
2019
accepted:
23
05
2019
pubmed:
28
7
2019
medline:
21
10
2020
entrez:
28
7
2019
Statut:
ppublish
Résumé
The aim of the study was to help quantify the protective effects of stimulant treatment on important functional outcomes in attention-deficit/hyperactivity disorder (ADHD) using the number needed to treat (NNT) statistic and examine whether these effects are moderated by sex. Subjects were derived from three independent samples, two similarly designed case-control, 10-year prospective follow-up studies of boys and girls with and without ADHD grown up and a cross-sectional randomized clinical trial of lisdexamfetamine on driving performance and behavior. For all studies, subjects were evaluated with structured diagnostic interviews. To measure psychopharmacologic treatment in the follow-up studies, we collected information about each subject's stimulant medication use, age at onset, and age at termination of treatment. Subjects in the driving study underwent two driving simulation assessments (premedication and after 6 weeks of treatment on lisdexamfetamine or placebo). For each outcome, we ran a logistic regression model that included an interaction between sex and treatment status. Lifetime rates were used to calculate the NNT statistic. We also calculated adjusted NNT statistics that accounted for sex, age, socioeconomic status, and family intactness. The NNTs were very low, ranging from 3 to 10. No interaction effects with sex were detected (all p > .05). The adjusted NNTs mostly remained the same with the exception of any substance use disorder, which increased after controlling for age. Stimulants have strong protective effects on functional outcomes in youth with ADHD that are not moderated by sex. These results support the critical importance of early identification and treatment of children with ADHD of both sexes.
Identifiants
pubmed: 31350122
pii: S1054-139X(19)30305-2
doi: 10.1016/j.jadohealth.2019.05.015
pmc: PMC6874726
mid: NIHMS1530540
pii:
doi:
Substances chimiques
Central Nervous System Stimulants
0
Lisdexamfetamine Dimesylate
SJT761GEGS
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
784-789Subventions
Organisme : NICHD NIH HHS
ID : R01 HD036317
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH050657
Pays : United States
Informations de copyright
Copyright © 2019 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
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