Children diagnosed with attention deficit disorder and their hospitalisations: population data linkage study

Abstract

Examine the hospital admission risk in young children who are subsequently diagnosed with attention deficit hyperactivity disorder (ADHD). We conducted a population-based, record linkage study. Records of all non-Aboriginal children under 18 years who met the DSMIV/ICD10 criteria for ADHD and prescribed stimulant medication in Western Australia between 2003 and 2007 (n = 11,902) were linked to two other health data systems-the hospital morbidity data system and the midwives notification system (MNS). The non-ADHD reference population (n = 27,304) was randomly selected from the MNS. Compared with controls, children under 4 years who subsequently were diagnosed and treated for ADHD were 70% [odds ratio (OR) 1.70; 95% confidence intervals (CI) 1.62-1.77] more likely to be admitted to hospital under 4 years of age. There was an increased risk for injury or poison (OR 1.73; 95% CI 1.59-1.88), respiratory disease (OR 1.49; 95% CI 1.40-1.59), ear disease (OR 2.03; 95% CI 1.86-2.21), infectious diseases (OR 1.68; 95% CI 1.53-1.85) and neurological conditions (OR 2.03; 95% CI 1.68-2.44). Admissions under 4 years of age for head injuries, burns, poisons, all other injuries, diseases of the tonsils and adenoids, asthma and early infections were all more common amongst children subsequently diagnosed with and treated for ADHD. There is significant early hospital morbidity for children subsequently diagnosed with ADHD. Multiple aetiologies and causal pathways need to be considered where some of these may include early infections, inflammatory conditions, epilepsy and injuries. Future studies should look at which of these conditions may be on the causal pathway or likely early markers for ADHD.

Genetic correlations among psychiatric and immune-related phenotypes based on genome-wide association data

“…115 Registry-based studies also provide support for increased incidence of ear infections (rg = 0.20 + 0.05, p = 2.0x10 -4 ) and psoriasis (rg = 0.23 + 0.07, p = 1.0x10 -3 ) among individuals with ADHD. 114,[116][117][118] On the other hand, ADHD was positively correlated with CRP (rg = 0.23 + 0.06, p = 2.0x10 -4 ), though a relatively large epidemiological study finds no association in affected individuals. 119 The negative correlation between anorexia nervosa and CRP (rg = -0.30 + 0.08, p = 1.0x10-4) is borne out in a recent meta-analysis of relevant studies.…”

Common infections with polyomaviruses and herpesviruses and neuropsychological development at 4 years of age, the Rhea birth cohort in Crete, Greece

“…Silva et al. have previously shown that infection‐related hospitalizations, including intestinal infections, bacterial and viral infections, pyrexia of unknown origin, acute respiratory infections, ear and tonsillar infections, were significantly associated with being diagnosed and treated for ADHD (Silva, Colvin, Hagemann, Stanley, & Bower, ). In contrast, we observed that children seropositive to ≥8 polyomaviruses presented less ADHD‐related symptomatology at 4 years of age compared to children seropositive to ≤3 polyomaviruses.…”

Health‐related impairments in young children with ADHD: a community‐based study

“…A growing body of research suggests that children with ADHD are at increased risk of overweight/obesity compared with non‐ADHD controls (Chen et al ; Cortese, Moreira‐Maia, St. Fleur et al ; Cortese & Vincenzi ; Erhart et al ; Halfon et al ; Waring & Lapane ; Yang et al ), particularly unmedicated children (Byrd et al ; Cortese et al ; Waring & Lapane ). Sleep problems, including difficulties with initiating and maintaining sleep, are more common in children with ADHD compared with their peers (Cortese et al , Sung et al ), as is the prevalence of serious injuries (Lange et al ; Silva et al ).…”