title: Medication for Attention-Deficit/Hyperactivity Disorder and Risk for Depression: A Nationwide Longitudinal Cohort Study.
abstract: Attention-deficit/hyperactivity disorder (ADHD) is associated with high rates of psychiatric comorbidity, including depression. However, it is unclear whether ADHD medication increases or decreases the risk for depression.
  
  
  
  We studied all individuals with a diagnosis of ADHD born between 1960 and 1998 in Sweden (N = 38,752). We obtained data for prescription of ADHD medication, diagnosis of depression and other psychiatric disorders, and sociodemographic factors from population-based registers. The association between ADHD medication and depression was estimated with Cox proportional hazards regression.
  
  
  
  After adjustment for sociodemographic and clinical confounders, ADHD medication was associated with a reduced long-term risk (i.e., 3 years later) for depression (hazard ratio = 0.58; 95% confidence interval, 0.51-0.67). The risk was lower for longer duration of ADHD medication. Also, ADHD medication was associated with reduced rates of concurrent depression; within-individual analysis suggested that occurrence of depression was 20% less common during periods when patients received ADHD medication compared with periods when they did not (hazard ratio = 0.80; 95% confidence interval, 0.70-0.92).
  
  
  
  Our study suggests that ADHD medication does not increase the risk of later depression; rather, medication was associated with a reduced risk for subsequent and concurrent depression.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Electronic address: zheng.chang@ki.se.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Chang
authors.affiliation: Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana.
authors.forename: Brian M
authors.initials: BM
authors.lastname: D'Onofrio
authors.affiliation: Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana.
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Quinn
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Paul
authors.initials: P
authors.lastname: Lichtenstein
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Medical Sciences, Örebro University, Örebro, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Larsson
mesh_terms: D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects*; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D002648:Child; D003866:Depressive Disorder / Q000139:chemically induced* / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D012306:Risk; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000697:Central Nervous System Stimulants
keywords: ADHD medication; Cohort study; Depression; Long-term effect; Short-term effect; Stimulants