Medication for childhood ADHD: Adults' outcomes and accounts after long-term treatment.

这个博士项目将评估成人（18岁以上）在儿童时期服用药物治疗ADHD 3年或更长时间的结果。MOCA将是一个混合方法的项目，使用定性研究（Strand 1）来检验第一人称描述，从而为流行病学研究（Strand 2）提供信息。这项研究将包括对患有多动症儿童和成年人的父母进行PPI调查。这些人也可能是链研究的参与者。据估计，欧洲目前有75万儿童和青少年（3-17岁）正在服用治疗注意力缺陷多动障碍（ADHD）的药物，其中大多数处方为哌醋甲酯。临床指南建议对严重的儿童多动症病例进行药物治疗，但其益处的证据主要来自美国的随机对照试验，大多数评估药物使用的时间较短，并有短期随访。关于成人结果的工作侧重于减少ADHD症状和评估公共卫生问题（例如犯罪、药物滥用）。据我们所知，没有人问过ADHD患者自己和ADHD儿童的父母，哪些结果对他们来说是重要的，也没有人测试过ADHD药物是否能改善这些结果。重要的是，在英国，儿童时期接受ADHD药物治疗的成年人的结果数据直到最近才可获得，因为ADHD药物是最近才大量用于儿童的，所以长期服用ADHD药物的年轻人的队列是新的。研究问题：Strand 11)患有多动症的成年人如何看待药物治疗，他们生活的哪些方面受到了影响？2)成年人和父母对ADHD药物治疗后的成人结果最感兴趣的是什么？儿童期长期治疗ADHD （bbbb3年）是否对成年期（服药后5-10年）的相关结果（在链1中建立）继续有影响？MethodsStrand 1。定性数据将通过焦点小组和半结构化访谈收集，其中一半患有ADHD的成年人服用药物超过3年，一半从未服用过药物。将进行一项在线调查，以确定哪些长期结果对ADHD患者最重要。链2。对英国人口代表性队列（英国千年队列研究）的分析将检查ADHD药物数据的趋势，并评估长期ADHD药物与链1中确定的成人结果的关联。将利用纵向重复测量混合效应模型对诊断为ADHD的个体与bbb - 3年服药、未服药和未服药的ADHD个体的轨迹进行比较。分析将使用SDQ多动评分控制ADHD的严重程度。在没有重复测量结果的情况下，分析将探讨治疗ADHD、未治疗ADHD和未治疗ADHD患者之间结果的差异。

This PhD project will assess outcomes for adults (aged 18+ years) who took medication to treat their ADHD for 3 years or more when they were children. MOCA will be a mixed methods project using qualitative research (Strand 1) to examine first person accounts that in turn inform epidemiological research (Strand 2). The research will involve PPI with parents of children with ADHD and adults with ADHD. These individuals may also be participants in the strand 1 studies.An estimated 750,000 children and adolescents (aged 3-17) in Europe are currently taking medication for Attention Deficit Hyperactivity Disorder (ADHD), with most prescribed methylphenidate. Clinical guidelines recommend drug treatment for severe cases of childhood ADHD, but evidence for benefits is largely drawn from randomised controlled trials in the US, most assessing medication use over short periods of time and with short term follow up. Work on adult outcomes has concentrated on reduction in ADHD symptoms and assessing public health concerns (e.g. criminality, substance abuse). To the best of our knowledge nobody has asked adults with ADHD themselves and parents of children with ADHD what outcomes are important to them, and tested whether these are improved by ADHD medication. Importantly, adult outcome data for those who received ADHD medication as children has only recently become available in the UK, as ADHD medication has only been given to children in large numbers relatively recently, so a cohort of young adults who have taken ADHD medication long-term is novel. Research questions:Strand 11) How do adults with ADHD regard medication, and what aspects of their lives have been affected as a result? 2) What adult outcomes after medication for ADHD are of most interest to adults and parents? Strand 23) Does long-term medication for ADHD (>3 years) in childhood continue to have an impact on outcomes of interest (established in strand 1) at adulthood (5-10 years after medication initiation)?MethodsStrand 1. Qualitative data will be collected via focus groups and semi-structured interviews with adults with ADHD, half of whom have taken medication for more than 3 years, and half who have never taken medication. An on-line survey will be conducted to establish which long-term outcomes are most important to people with ADHD. Strand 2. Analysis of a UK population-representative cohort (the UK Millennium Cohort Study) will examine trends in ADHD medication data, and assess the association of long term ADHD medication with adult outcomes identified in strand 1. Comparisons of the trajectories of individuals with diagnosed ADHD and >3 years medication, ADHD with no medication and no ADHD will be conducted utilising longitudinal repeated measures mixed effects modelling. The analyses will be controlling for ADHD severity using Strengths and Difficulties SDQ Hyperactivity scores. Where repeated measures on outcomes are not available, analyses will explore differences in outcomes between those with medicated ADHD, un-medicated ADHD and no ADHD.