American Statistical Association
New York City
Metropolitan Area Chapter

New York State Psychiatric Institute
at Columbia University Medical Center
Biostatistics Seminar



Madelyn S. Gould, Ph.D., M.Ph.
Marjorie Kleinman, M.S.
Division of Child & Adolescent Psychiatry
New York State Psychiatric Institute


The authors sought to determine whether a significant association exists between the use of stimulants and the rare event of sudden-unexplained death in children and adolescents.

Methods: A matched case-control design was performed. State vital statistics mortality data from 1985-1996 were used to identify 564 cases of sudden death at ages 7 through 19 years, occurring across the United States, and a matched group of 564 young people who died as passengers in motor vehicle traffic accidents. The primary exposure measure was the presence of amphetamine, dextroamphetamine, methamphetamine, or methylphenidate, based on informant reports or as noted in medical examiner records, toxicology results, or death certificates.

Results: Ten (1.8%) of the sudden-unexplained-death cases were determined to have been taking stimulants, specifically methylphenidate; in contrast, use of stimulants was found in only two subjects in the comparison group (0.4%), only one involving methylphenidate use. A significant association of stimulant use with sudden-unexplained death emerged from the primary analysis based on exact conditional logistic regression (odds ratio=7.4; 95% confidence interval=1.4 to 74.9). A comprehensive series of sensitivity analyses yielded qualitatively similar findings.

Conclusions: This case-control study provides support for an association between the use of stimulants and sudden-unexplained death among children and adolescents. Although sudden unexplained death is a rare event, this finding should be considered in the context of other data about the risk and benefit of stimulants in medical treatment.

Biographical Note

Madelyn Gould is a Professor at Columbia University in the Division of Child and Adolescent Psychiatry (College of Physicians & Surgeons) and Department of Epidemiology (School of Public Health), and a Research Scientist at the New York State Psychiatric Institute. Marjorie Kleinman is a Research Scientist at the New York State Psychiatric Institute and in the Division of Child and Adolescent Psychiatry. Dr. Gould and Ms. Kleinman have been collaborating for decades. Their research has focused on the epidemiology of youth suicide, as well as the evaluation of youth suicide prevention interventions. Specific projects examine risk factors for teenage suicide; various aspects of cluster suicides; the impact of the media on suicide; the effect of a peers suicide on fellow students; suicide crisis intervention programs in schools; the effect of youth suicide screening programs, and the utility of telephone crisis services. Today’s presentation is one of the few non-suicide-related projects on which they have worked together.

Date: Tuesday, March 9, 2010
Time: 3:30 - 4:30 P.M.
Location: New York State Psychiatric Institute
1051 Riverside Drive
6th Floor Multipurpose Room (6602)
New York, New York


Coffee: 3:15 to 3:30 P.M.
Reception: 4:30 to 5:00 P.M.

Home Page | Chapter News | Chapter Officers | Chapter Events
Other Metro Area Events | ASA National Home Page | Links To Other Websites
NYC ASA Chapter Constitution | NYC ASA Chapter By-Laws

Page last modified on March 6, 2010

Copyright © 1998-2010 by New York City Metropolitan Area Chapter of the ASA
Designed and maintained by Cynthia Scherer
Send questions or comments to