Methylphenidate and the risk of psychotic disorders and hallucinations in children and adolescents in a large health system

Man, Kenneth K.C. and Coghill, David and Chan, Esther W. and Lau, Wallis C.Y. and Hollis, Chris and Liddle, Elizabeth and Banschewski, Tobias and McCarthy, Suzanne and Neuberg, Antje and Sayal, Kapil and Ip, Patrick and Wong, Ian C.K. (2016) Methylphenidate and the risk of psychotic disorders and hallucinations in children and adolescents in a large health system. Translational Psychiatry, 6 . e956. ISSN 2158-3188

[img]
Preview
PDF - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Available under Licence Creative Commons Attribution.
Download (390kB) | Preview

Abstract

Previous studies have suggested that risk of psychotic events may be increased in children exposed to methylphenidate (MPH). However, this risk has not been fully examined and the possibility of confounding factors has not been excluded. Patients aged 6-19 years who received at least one MPH prescription were identified using Hong Kong population-based electronic medical records on the Clinical Data Analysis & Reporting System (2001-2014). Using the self-controlled case series design, relative incidence of psychotic events was calculated comparing periods when patients were exposed to MPH with non-exposed periods. Of 20 586 patients prescribed MPH, 103 had an incident psychotic event; 72 (69.9%) were male and 31 (30.1%) female. The mean age at commencement of observation was 6.95 years and the mean follow-up per participant was 10.16 years. On average, each participant was exposed to MPH for 2.17 years. The overall incidence of psychotic events during the MPH exposure period was 6.14 per 10 000 patient-years. No increased risk was found during MPH exposed compared to non-exposed periods (incidence rate ratio (IRR) 1.02 (0.53-1.97)). However, an increased risk was found during the pre-exposure period (IRR 4.64 (2.17-9.92)). Results were consistent across all sensitivity analyses. This study does not support the hypothesis that MPH increases risk of incident psychotic events. It does indicate an increased risk of psychotic events prior to the first prescription of MPH, which may be due to an association between psychotic events and the behavioural and attentional symptoms that led to psychiatric assessment and initiation of MPH treatment.

Item Type: Article
Keywords: Attention-Deficit/Hyperactivity Disorder; Psychotic disorder; Hallucinations; Methylphenidate; Self-Controlled Case Series; Hong Kong
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Psychiatry and Applied Psychology
Identification Number: https://doi.org/10.1038/tp.2016.216
Depositing User: Eprints, Support
Date Deposited: 25 Nov 2016 15:16
Last Modified: 25 Nov 2016 15:33
URI: http://eprints.nottingham.ac.uk/id/eprint/38461

Actions (Archive Staff Only)

Edit View Edit View