Attention deficit hyperactivity disorder, physical abuse and methylphenidate treatment in children

A growing number of studies show an association between attention deficit hyperactivity disorder and physical abuse in childhood. We examined temporal associations of physical abuse risk with methylphenidate treatment in children with attention deficit hyperactivity disorder. Using Hong Kong electronic medical records, we conducted a self-controlled case series study in 1,064 children (5–16 years old) who were treated with methylphenidate and also experienced physical abuse. Compared with non-medicated periods, a higher risk of abuse was observed shortly before treatment initiation (incidence rate ratio = 4.49; 95% confidence interval = 3.76–5.36). After treatment initiation, the risk was comparable to that in non-medicated periods (incidence rate ratio = 0.90; 95% confidence interval = 0.63–1.29), followed by a 37% reduction during subsequent treatment. These findings are consistent with the hypothesis that methylphenidate treatment in children with attention deficit hyperactivity disorder is associated with a reduced risk of becoming a victim of physical abuse.