Does pharmacotherapy for attention-deficit/hyperactivity disorder predict risk of later major depression?
OBJECTIVE
This study's goal was to determine among youths with attention-deficit/hyperactivity disorder (ADHD) how the history of ADHD pharmacotherapy influenced the risk of developing major depressive disorder (MDD), compared to other commonly reported predictors.


METHODS
Diagnostic and treatment history data were analyzed retrospectively in 75 youths 11-18 years old with definite or probable ADHD, enrolled in an observational study at a tertiary mental health clinic. Subjects with histories of MDD (H/o MDD) (n = 36) were compared to others who had never been depressed (Never-Depressed) (n = 39) regarding histories of ADHD pharmacotherapy, psychopathology and other potential covariates of MDD risk.


RESULTS
H/o MDD subjects reported longer delays before initiating ADHD pharmacotherapy, were more often female, reported having experienced more traumatic event types, and had higher rates of early anxiety and externalizing disorders. With all covariates allowed to enter a backward stepwise Cox regression of survival time till first episodes of MDD, only two variables remained in the model. The time-dependent variable, ADHD pharmacotherapy, prolonged survival times (p = .012), while having experienced more traumatic event types shortened them (p = .001).


CONCLUSIONS
This study provides preliminary evidence that pharmacotherapy for ADHD may have a protective effect in ADHD youths, reducing the risk of later MDD.
Daviss
W Burleson
WB
Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA. davissw@uthscsa.edu
Birmaher
Boris
B
Diler
Rasim S
RS
Mintz
James
J
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D016022:Case-Control Studies; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors
D000697:Central Nervous System Stimulants