Methylphenidate and the risk of burn injury among children with attention-deficit/hyperactivity disorder

Vincent Chin Hung Chen, Yao Hsu Yang, Ting Yu Kuo, Mong Liang Lu, Wei Ting Tseng, Tsai Yu Hou, Jia Ying Yeh, Charles Tzu Chi Lee, Yi Lung Chen, Min Jing Lee, Michael E. Dewey, Michael Gossop

Research output: Contribution to journalArticle

Abstract

AIMS: Attention-deficit/hyperactivity disorder (ADHD) is associated with a higher risk of burn injury than in the normal population. Nevertheless, the influence of methylphenidate (MPH) on the risk of burn injury remains unclear. This retrospective cohort study analysed the effect of MPH on the risk of burn injury in children with ADHD.

METHOD: Data were from Taiwan's National Health Insurance Research Database (NHIRD). The sample comprised individuals younger than 18 years with a diagnosis of ADHD (n = 90 634) in Taiwan's NHIRD between January 1996 and December 2013. We examined the cumulative effect of MPH on burn injury risk using Cox proportional hazards models. We conducted a sensitivity analysis for immortal time bias using a time-dependent Cox model and within-patient comparisons using the self-controlled case series model.

RESULTS: Children with ADHD taking MPH had a reduced risk of burn injury, with a cumulative duration of treatment dose-related effect, compared with those not taking MPH. Compared with children with ADHD not taking MPH, the adjusted hazard ratio for burn injury was 0.70 in children taking MPH for <90 days (95% confidence interval (CI) 0.64-0.77) and 0.43 in children taking MPH for ≥90 days (95% CI 0.40-0.47), with a 50.8% preventable fraction. The negative association of MPH was replicated in age-stratified analysis using time-dependent Cox regression and self-controlled case series models.

CONCLUSION: This study showed that MPH treatment was associated with a lower risk of burn injury in a cumulative duration of treatment dose-related effect manner.

Original languageEnglish
Article numbere146
Pages (from-to)e146
JournalEpidemiology and Psychiatric Sciences
Volume29
DOIs
Publication statusPublished - Jul 20 2020

Keywords

  • Attention-deficit/hyperactivity disorder
  • burn injury
  • methylphenidate

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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  • Cite this

    Chen, V. C. H., Yang, Y. H., Yu Kuo, T., Lu, M. L., Tseng, W. T., Hou, T. Y., Yeh, J. Y., Lee, C. T. C., Chen, Y. L., Lee, M. J., Dewey, M. E., & Gossop, M. (2020). Methylphenidate and the risk of burn injury among children with attention-deficit/hyperactivity disorder. Epidemiology and Psychiatric Sciences, 29, e146. [e146]. https://doi.org/10.1017/S2045796020000608