Young people on amphetamines for ADHD have twice the psychosis risk compared to other stimulants

Title: Young people on amphetamines for ADHD have twice the psychosis risk compared to other stimulants, study says

That is a recent news story headline …

Twice … the numbers are 0.1% to 0.21%
This is how statistics can be made to sound big when there is very little change.

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Funny! I wasn’t going to read the topic because I thought it sounded like fake news. And that was kind of your point.

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Give me some time to deep dive on this story for a better understanding of the study

I’ll stick to my coffee thanks.

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Put another way, it’s a change in rate from 100 people in 100,000 to 210 people in 100,000. The percentages sound small but anything that doubles a risk factor, however small, is big news in medical journals.

(edit - I’m just trying to explain what a difference from 0.1% to 0.21% means in terms of incidence rate)

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The title of this post just begs for so many comments.
I shall slap my twitchy fingers…:rofl:

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Have you read the article? As the article was not linked I had figured this was a fictitious scenario.

You are seemingly running into the same problem as we are missing information. How do you know the group is even 100,000 people? It may be based on a group of 1000, where it changed from 1 to 2. Or based on the population of ADHD patients which I’ve read is estimated around 13% of global population.

This is the problem with filling in the gaps for a headline rather than reading the article. Headlines are intentionally misleading as they are intended to attract attention rather than be truthful.

Click-Bait is today’s standard for headlines.

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Thanks @jast
@jswilson64 so the stat seems to be based on a group 221,486 of young adults ages 13-25 with ADHD that being prescribed either a amphetamine or methylphenidate. It seems half for each drug. methylphenidate had a 0.1% of a single event of psychosis while amphetamines has 0.21% of a single event of psychosis.

These are very small percentages in a particularly small group and it seems there isn’t a non-medicated control group to compare it to.

Also relevant

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008925/

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No VIDEO blaring at me AUTOMATICALLY!?!
Ugh! Hard words.
What is “comorbidity”?!? Or “schizo…something”…
Do I have to look stuff UP?
SQUIRREL!

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Your article highlights much of the problem in the original article on the actual level of studies. Good link. Kind of stated the research is a mixed bag and many studies contradict each other on drug prescriptions and effects on psychosis.

I don’t - but I scanned the headlines this morning and saw this story was in the New England Journal of Medicine. I have worked in medical research and currently work in statistics so I know that a study in NEJM is probably pretty solid and that it’s probably safe to extrapolate the incidence rate from the study to the population as a whole.

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That is a bold stance, and highlights many opportunities to get caught suggesting inaccurate information. It seemed this study was never intended to be extrapolated to the population of the world as a whole given the group monitored was very specific and not representative of global population.

https://www.nejm.org/doi/full/10.1056/NEJMoa1813751?query=featured_home

It’s kind of fun to compare/contrast the experience from reading in on CNN vs. NEJM vs. {x}…

Yeah, I find it very problematic. I just taught correlation and causation earlier this week. :wink:

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CONCLUSIONS

Among adolescents and young adults with ADHD who were receiving prescription stimulants, new-onset psychosis occurred in approximately 1 in 660 patients. Amphetamine use was associated with a greater risk of psychosis than methylphenidate. (Funded by the National Institute of Mental Health and others.

I don’t see a causation attributed there.

Comorbidity is when you have more than one disorder present in the same person/client/patient. The science as a whole is still growing to understand those connections and how they are related… So far the only one we see in overwhelming conjunction is Depression and Anxiety.

Not as much as you would think from the industry perspective. The key here is, which @sewingstuff just mentioned, that so long as the datum is presented as correlative and not causal then its fine. and pretty much everyone in that industry is hammered with that understanding, so its a given. The article itself does not postulate causation nor did @jswilson64. The Media however will run with that kind of crap and then these discussions pop up.

So the takeaway here, and for future iterations of similar media presented articles, is look at this as an interesting piece of information that gets us closer to understanding neurochemistry interactions regarding mental illness and medications. Don’t assume its a direct cause, if you take X medications, you will now have X% times higher possibility of having a psychotic episode.

Source- MA in Psychology, former licensed therapist.

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I didn’t suggest causation. I found the extrapolating a narrow study of a narrow population to the population of the world as the bold statement.

Are you saying the industry accepts this as a practice? I studied psychology and sociology in college and representative studies of the groups is what we used for extrapolation to just those groups, not the global population as a whole.

I can test the population of the DMS for a trait but I wouldn’t claim the correlation of that trait is the same for the global population. DMS is not a representative example of global population. It is like saying my bike is blue, thus I would be accurate in claiming all bikes are probably blue.