The Protective Role of Attention-Deficit Hyperactivity Disorder Medication Against Post-disaster Psychopathology in Children: A Naturalistic Study After the 2023 Turkiye Earthquakes

INTRODUCTION: Children with attention-deficit hyperactivity disorder (ADHD) can be susceptible to psychological distress after traumatic events due to their difficulties in emotional regulation and stress reactivity. The present study explores psychiatric symptoms and the impact of pharmacological treatment in ADHD children following the 2023 Kahramanmaras earthquakes in Turkiye. METHODS: The study included 124 children diagnosed with ADHD and 58 controls without ADHD aged 8-12 years. ADHD children were divided into two subgroups: those who maintained ADHD medication post earthquake (ADHD-MED, N = 60) and those who discontinued it (ADHD-nonMED, N = 64). Psychological assessments included the Children's Depression Inventory (CDI), State-Trait Anxiety Inventory (STAI), and Children's Revised Impact of Event Scale-13 (CRIES-13). RESULTS: Significant differences were observed between the three groups in CDI, STAI, and CRIES-13 scores. The ADHD-nonMED group exhibited the highest scores of depressive, anxiety, and post-traumatic stress symptoms. In contrast, the ADHD-MED group showed intermediate scores, closer to those of the control group. The likelihood of clinical cut-off scores for severe anxiety and post-traumatic stress disorder was significantly greater in the ADHD-nonMED group compared to both the ADHD-MED and control groups. CONCLUSIONS: Non-medicated ADHD children experienced more severe psychological symptoms after the earthquakes. Continued pharmacological treatment may have a protective role against post-disaster psychopathology in ADHD children.