台灣兒童青少年精神醫學會新聞稿
回應2015年12月5日新聞報導密西根大學之相關研究「青少年接受過動藥物治療 增遭霸凌機率」， "美國最近1份學生自填問卷研究發現，接受注意力不足過動症（ADHD）藥物治療的兒童和青少年(和未接受ADHD藥物治療者一樣)，被霸凌的機率是非ADHD孩子的兩倍。"，針對新聞內容所引用之ADHD藥物治療與霸凌之間關係的研究，本會為讓社會大眾有正確之疾病與用藥觀念，須要做以下之澄清及呼籲：
（1）ADHD是兒童期常見的精神疾病，主要的症狀為注意力不足、過動以及衝動，根據國內與國外的臨床研究結果顯示，藥物治療為此疾病有效的治療。
（2）根據由美國國家精神衛生研究院（National Institute of Mental Health）與教育部（Department
of Education）支援下所進行的 “注意力不足過動症之多模式治療 (Multimodal Treatment of Attention Deficit Hyperactivity Disorder,
MTA)”研究結果顯示，單用藥物治療組及藥物合併行為治療組明顯優於單用密集行為治療組和例行性社區照護組，而單用藥物治療組與藥物合併行為治療組的療效並無明顯差異，因此在治療ADHD核心症狀時，藥物是絕對不能忽略的治療選項。
（3）根據「小兒心理學期刊」（Journal of Pediatric Psychology）所刊載之艾普斯坦（Quyen
M Epstein-Ngo）等作者的研究論文原文，雖然與非ADHD青少年相比，接受藥物治療的ADHD青少年被霸凌的比例較高，但若與沒有接受藥物治療的ADHD青少年相比，接受藥物治療的ADHD青少年被霸凌的比例並未增加。因此，ADHD本身和霸凌有關並非藥物治療，不宜斷章取義出現新聞標題所述「青少年接受過動藥物治療
增遭霸凌機率」的結論。原論文標題為「分送治療ADHD藥物和青少年霸凌」，會分送藥物和跟有ADHD藥物的同學要藥的青少年有霸凌的機率較高，這是行為障礙問題和藥物治療本身無關。
（4）艾普斯坦（Quyen M Epstein-Ngo）等作者也在研究論文中坦言這項研究的諸多限制，包括只有依賴個案的主觀報告而缺乏客觀的評估，以及橫斷面 (cross-sectional) 的研究無法推論因果關係等，這些因素都會明顯影響研究結果的判讀。
（5）由以上之說明，希望能讓社會大眾了解，目前並無科學證據顯示藥物治療會增加ADHD孩子被霸凌的機率，相反地，藥物治療是目前ADHD的標準治療方式之ㄧ。
臺灣兒童青少年精神醫學會
理事長 高淑芬
http://www.ncbi.nlm.nih.gov/pubmed/26590265
* Abstract
J Pediatr Psychol. 2015 Nov 19. pii: jsv105. [Epub ahead of print]
Diversion
of ADHD Stimulants and Victimization Among Adolescents. Epstein-Ngo QM1, McCabe
SE2, Veliz PT2, Stoddard SA3, Austic EA4, Boyd CJ5. Author information
*
1Institute for Research on Women and Gender, University of Michigan Institute
for Clinical and Health Research, University of Michigan Injury Center,
University of Michigan qen@umich.edu.
*
2Institute for Research on Women and Gender, University of Michigan.
* 3School
of Nursing, University of Michigan School of Public Health, University of
Michigan.
*
4Institute for Clinical and Health Research, University of Michigan Injury
Center, University of Michigan Department of Emergency Medicine, University of
Michigan.
*
5Institute for Research on Women and Gender, University of Michigan School of
Nursing, University of Michigan Department of Psychiatry, Addiction Research
Center, University of Michigan.
Abstract
OBJECTIVE:
To examine
whether a recent prescription for stimulant medication is associated with peer
victimization among youth with attention deficit/hyperactivity disorder (ADHD).
METHODS: Data from 4,965 adolescents attending five public schools who
completed an annual web survey over 4 years were used to examine recent
stimulant medication prescription and self-reported frequent victimization.
RESULTS: Adolescents with ADHD and recent stimulant prescription reported more
victimization than those without ADHD, but similar to adolescents with ADHD and
no recent prescription. Adolescents with ADHD and past 12-month diversion of
their prescribed stimulants were at greatest risk of 12-month frequent
victimization compared with adolescents without ADHD and adolescents with ADHD
but no recent prescription. Youth approached to divert reported more
victimization than youth not approached. Youth who diverted reported more
victimization than those who did not divert. CONCLUSIONS: Close
parent-prescriber collaboration is needed to ensure effective medical treatment
for ADHD without greater risk for victimization and treatment failure.
© The
Author 2015. Published by Oxford University Press on behalf of the Society of
Pediatric Psychology. All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.
KEYWORDS:
adolescent(s);
attention deficit/hyperactivity disorder; crime and violence; prescription
stimulant(s); risk behaviors
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