Cited by 175Attention Deficit Hyperactivity DisorderInjury Epidemiology and PreventionPatient Safety and Medication Errors

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Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis

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Ruiz-Goikoetxea, Maite, Cortese, Samuele, Aznarez-Sanado, Maite, Magallón, Sara, Alvarez Zallo, Noelia, Luis, Elkin O., de Castro-Manglano, Pilar, Soutullo, Cesar, Arrondo, Gonzalo·2018·Neuroscience & Biobehavioral Reviews

DOI 10.1016/j.neubiorev.2017.11.007

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Abstract

A systematic review with meta-analyses was performed to: 1) quantify the association between ADHD and risk of unintentional physical injuries in children/adolescents ("risk analysis"); 2) assess the effect of ADHD medications on this risk ("medication analysis"). We searched 114 databases through June 2017. For the risk analysis, studies reporting sex-controlled odds ratios (ORs) or hazard ratios (HRs) estimating the association between ADHD and injuries were combined. Pooled ORs (28 studies, 4,055,620 individuals without and 350,938 with ADHD) and HRs (4 studies, 901,891 individuals without and 20,363 with ADHD) were 1.53 (95% CI=1.40,1.67) and 1.39 (95% CI=1.06,1.83), respectively. For the medication analysis, we meta-analysed studies that avoided the confounding-by-indication bias [four studies with a self-controlled methodology and another comparing risk over time and groups (a "difference in differences" methodology)]. The pooled effect size was 0.879 (95% CI=0.838,0.922) (13,254 individuals with ADHD). ADHD is significantly associated with an increased risk of unintentional injuries and ADHD medications have a protective effect, at least in the short term, as indicated by self-controlled studies.

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Authors: Ruiz-Goikoetxea, M., Cortese, S., Aznarez-Sanado, M., Magallón, S., Alvarez Zallo, N., Luis, E. O., de Castro-Manglano, P., Soutullo, C., & Arrondo, G.
Affiliations: Servicio Navarro de Salud (ES)
NYU Langone Health (US)
Universidad de Navarra (ES)
Corresponding author: Arrondo, Gonzalo
ORCID: Ruiz-Goikoetxea, Maite
Cortese, Samuele
Magallón, Sara
Arrondo, Gonzalo
Venue: Neuroscience & Biobehavioral Reviews
Publisher: Elsevier BV
Published: 2018-01
Volume: 84
Pages: 63-71
ISSN: 0149-7634 (ISSN-L)
DOI: 10.1016/j.neubiorev.2017.11.007
OpenAlex: W2769961275
Cited by: 175
References: 116
Citations by year: 2026: 14 · 2025: 20 · 2024: 21 · 2023: 26 · 2022: 22 · 2021: 36 · 2020: 14 · 2019: 14 · 2018: 7
FWCI: 1.49
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Neuroscience & Biobehavioral Reviews (publishedVersion, cc-by)
PubMed (publishedVersion)
ePrints Soton (University of Southampton) (acceptedVersion)
Deposito Adademico Digital Universidad De Navarra (University of Navarra) (submittedVersion, other-oa)
Funders: 2016 research program of the Health department of the Government of Navarre (89/2016)
operational programme of the European Regional Development Fund
Solent National Health Service (NHS) Trust, UK
Association for Child and Adolescent Mental Health (ACAMH)
Caja Navarra Foundation and Shire
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
Keywords: attention deficit hyperactivity disorder, unintentional injuries, childhood injuries, adolescents, ADHD medication, injury risk, confounding by indication, self-controlled study, confounding by treatment
MeSH terms: Accidents, Attention Deficit Disorder with Hyperactivity, Humans, Proportional Hazards Models, Odds Ratio, Protective Agents

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Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis

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