road trauma in teenage male youth with childhood disruptive behavior disorders a population based analysis路创伤与儿童破坏性行为障碍十几岁的男青年人口为基础的分析.pdfVIP

Road Trauma in Teenage Male Youth with Childhood Disruptive Behavior Disorders: A Population Based Analysis Donald A. Redelmeier1,2,3,4*, William K. Chan1,3, Hong Lu3 1 Department of Medicine, University of Toronto, Toronto, Canada, 2 Clinical Epidemiology Program, Sunnybrook Health Sciences Centre, Toronto, Canada, 3 Institute for Clinical Evaluative Sciences in Ontario, Ontario, Canada, 4 Patient Safety Service, Sunnybrook Research Institute, Toronto, Canada Abstract Background: Teenage male drivers contribute to a large number of serious road crashes despite low rates of driving and excellent physical health. We examined the amount of road trauma involving teenage male youth that might be explained by prior disruptive behavior disorders (attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder). Methods and Findings: We conducted a population-based case-control study of consecutive male youth between age 16 and 19 years hospitalized for road trauma (cases) or appendicitis (controls) in Ontario, Canada over 7 years (April 1, 2002 through March 31, 2009). Using universal health care databases, we identified prior psychiatric diagnoses for each individual during the decade before admission. Overall, a total of 3,421 patients were admitted for road trauma (cases) and 3,812 for appendicitis (controls). A history of disruptive behavior disorders was significantly more frequent among trauma patients than controls (767 of 3,421 versus 664 of 3,812), equal to a one-third increase in the relative risk of road trauma (odds ratio = 1.37, 95% confidence interval 1.22–1.54, p ,0.001). The risk was evident over a range of settings and after adjustment for measured confounders (odds ratio 1.38, 95% confidence interval 1.21–1.56, p ,0.001). The risk explained about one-in-20 crashes, was apparent years before the event, e