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| |  Early Pharmacotherapy in Children With ADHD Might Reduce Risk of Comorbid Depressive Disorder: Presented at AACAP By Maria Bishop BOSTON, MA -- November 1, 2007 -- Pharmacotherapy for attention-deficit hyperactivity disorder (ADHD) does not increase the risk of major depressive disorder (MDD) in children, and, in fact, may reduce the risk of later comorbid MDD, according to research presented here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP). While animal studies have suggested a link between MDD and early exposure to stimulants, in this trial a link was found between delayed ADHD pharmacotherapy and higher risk of eventual MDD in youths with ADHD, noted lead author W. Burleson Daviss, MD, Associate Professor, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States. Youths with ADHD have rates of MDD that are 5.5 times higher than the rate in the general population, although ADHD usually occurs several years before the onset of MDD. In their retrospective, case-control study, Dr. Daviss and colleagues utilised data from consecutive research evaluations of adolescents 11 to 18 years old with ADHD who were participating in an observational study. Two groups were categorised and compared in univariate analysis: youths with histories of a major depressive episode (never depressed) and youths with no history of MDD or minor depressive episodes (history of MDD). The two groups had similar ages of onset and current symptoms of ADHD. However, the history of MDD group had significantly later fist pharmacotherapy for ADHD (P =.002). Allowing other significant predictors to enter a backward stepwise Cox Regression analysis, the time-dependent variable ADHD pharmacotherapy emerged as the only significant predictor of MDD after ADHD onset (P =.037). Early externalising and early anxiety disorders did not show a trend toward prediction of MDD. Although it did not remain a variable in a separate stepwise regression analysis, female gender showed a trend toward being a significant predictor of MDD (P =.07). Females also showed a greater delay, however, in receiving ADHD pharmacotherapy. Dr. Daviss concluded that, "These results will require replication in an independent sample of ADHD youths -- ideally using prospective rather than retrospective observations." He added that further studies might explore the link between delayed pharmacotherapy and comorbid MDD (e.g., family psychopathology, poor parenting, environment).
[Presentation title: Does Early Pharmacotherapy for ADHD Protect Against Risk of Later Depression? Abstract B9]
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