(23) Comorbidity, Trauma and Mortality in Children and Young Adults Using ADHD Medications in Quebec Between 2000 and 2020

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1068

Presenting Author(s)

Carlotta Lunghi
– Pharmacology Unit � Department of Medical and Surgical Sciences � University of Bologna, Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Bologna, Italy

Co-Author(s)

Helen-Maria Vasiliadis, MSc, PhD
– Département des sciences de la santé communautaire, Université de Sherbrooke, Canada
Elham Rahme, PhD
– Associate Professor, McGill University, Montreal, QC, Canada
Louis Rochette
– Bureau d’information et d’études en santé des populations, Institut National de Santé Publique du Québec, QC, Canada
Martin Gignac
– 5. Montreal Children's Hospital, McGill University Montreal, QC, Canada
Victoria Massamba
– Bureau d’information et d’études en santé des populations, Institut National de Santé Publique du Québec, QC, Canada
Fatoumata Binta Diallo
– Institut national de santé publique du Québec, QC, Canada
Alvine Fansi
– Direction des affaires universitaires, de l'enseignement et de la recherche Centre intégré universitaire de santé et de services sociaux de l'Ouest-de-l'Île-de-Montréal, QC, Canada
Samuele Cortese
– University of Southampton, England, United Kingdom
Alain Lesage
– Department of Psychiatry, University of Montreal, QC, Canada

Background: Among the Canadian provinces, Quebec showed one of the highest trends in increased diagnostic rates of ADHD between 2000 and 2012. Recent prevalence estimates of ADHD are 6.6%, 18.9%, and 15.5% for those aged ≤11, 12-17, and 18-24 years, respectively. Prescription rates for ADHD medications in Quebec have increased from 1.9% to 7.7% between 2000 and 2020.

Objectives: To describe comorbidity and health outcomes of children, adolescents and young adults using ADHD medications in Quebec. We hypothesize differences in prevalence estimates of comorbidity, trauma-related events and mortality according to ADHD medication use.

Methods: Data were drawn from the Quebec Integrated Chronic Disease Surveillance System between 2000 and 2018. The cohort included residents covered under the public drug insurance plan between April 1st, 2000, and March 31st, 2020. Individuals between 1 and 24 years entered the cohort at either a first physician claim or hospital diagnosis of ADHD or an ADHD medication claim. Medications included amphetamine-derivatives and methylphenidate-based psychostimulants and non-psychostimulants. The study population was categorized with respect to the presence of an ADHD medication and diagnosis [ADHD medication only n=34,528, ADHD diagnosis only n=20,574, both n=59,610 (the majority had medication and diagnosis within 90 days)]. Prevalence estimates regarding psychiatric comorbidities; trauma-related events (ambulatory records); and mortality (all-cause; trauma-related without suicide [i.e., non-intentional] and suicide; other causes) according to the study group will be presented. Differences will be based on 99% CI around estimates.

Results: In individuals with ADHD medication only, diagnosis only and both, the prevalence of lifetime psychiatric comorbidity was 78.5%, 65.8% and 79.3%; that of traumatic-related events in ambulatory settings was 48.3%, 49.4%, and 59.0%, respectively. The prevalence of all-cause mortality was 0.19%, 0.33%, and 0.17%, with that of trauma-related mortality being 0.06%, 0.05%, and 0.07%, respectively.

Conclusions: Differences exist in the comorbidities, traumatic-related events and mortality between individuals using ADHD medications and not. Within-subject analyses are underway and will assess the association between ADHD medication use, suicide behaviours, trauma, and mortality.