Hyperactivity and the Psychological Burden of Perthes Disease

Perry, Daniel C.; Pope, Daniel; Bruce, Colin; Dangerfield, Peter; Hall, Andrew J.; Platt, Mary Jane

doi:10.1097/bpo.0b013e31829494c0

Cited by 14 publications

(10 citation statements)

References 15 publications

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“…Especially in adults, neurobehavioral aspects of ADHD can change from hyperactivity to more inattentiveness or depression (Yang et al 2013), which may explain the higher risk of depression in individuals with LCPD than in their controls, and which also supports our hypothesis (2). While the association of LCPD with “emotional symptoms” (Perry et al 2013) has been described, to our knowledge ours is the first study to investigate associations between LCPD and depression as a formal diagnosis. The higher risk of depression could also be a result of the psychological burden of LCPD as a response to chronic pain, restriction in physical activity, and the relatively uncertain outcome of LCPD compared to other chronic diseases (Cassileth et al 1984, Moussavi et al 2007).…”

Section: Discussionmentioning

confidence: 91%

“…In 1993, Loder et al (1993) found in a group of 24 children with LCPD that one-third had abnormally high scores in profiles associated with ADHD. In a case-control study of 619 individuals with LCPD between the ages of 0 and 14 years, Perry et al (2013) found hyperactivity associated with LCPD but could not find a significantly higher risk of diagnosis of ADHD (Perry et al 2012a). Although ADHD is commonly diagnosed between 5 and 8 years of age, a delay between age at onset and age at diagnosis is not unusual.…”

Section: Discussionmentioning

confidence: 95%

“…In a case-control study, Perry et al (2013) revealed associations between LCPD and the domain “Inattention-Hyperactivity” of the Goodman 25-item Strength and Difficulties Questionnaire. Furthermore, individuals with LCPD have a higher risk of injuries requiring hospitalization than controls without the disease, which could derive from hyperactive and risk-taking behavior (Hailer et al 2012).…”

mentioning

confidence: 99%

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Legg-Calvé-Perthes disease and the risk of ADHD, depression, and mortality

Hailer¹,

Nilsson²

2014

Acta Orthopaedica

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Background and purpose Hyperactive behavior pattern (such as attention deficit hyperactivity disorder (ADHD)) is proposed to be present in individuals with Legg-Calvé-Perthes disease (LCPD). We investigated whether individuals with LCPD have a higher risk of ADHD, depression, and mortality.Subjects and methods We identified 4,057 individuals with LCPD in Sweden during the period 1964–2011. 40,570 individuals without LCPD were randomly selected from the Swedish general population and matched by year of birth, sex, and region (control group). We used Cox proportional hazard regression to estimate the relative risks.Results Compared to the control group, individuals with LCPD had a raised hazard ratio (HR) of 1.5 (95% CI: 1.2–1.9) for ADHD. The risks were higher for female individuals (HR = 2.1, CI: 1.3–3.5) than for male individuals (HR = 1.4, CI: 1.1–1.8). Individuals with LCPD had a modestly higher hazard ratio for depression (HR = 1.3, CI: 1.1–1.5) than the control group. Furthermore, individuals with LCPD had a slightly higher mortality risk than the control group (HR = 1.2, CI: 1.0–1.4)Interpretation Individuals with LCPD have a higher risk of ADHD. Hyperactivity could expose the femoral head to higher mechanical stress and contribute to the etiology of LCPD. The higher risk of depression may be due to the burden of LCPD itself or could reflect neurobehavioral aspects of ADHD changing into depression later in life. Individuals with LCPD have a higher mortality risk, with higher risk of suicide and cardiovascular diseases.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 95%

mentioning

confidence: 99%

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Legg-Calvé-Perthes disease and the risk of ADHD, depression, and mortality

Hailer¹,

Nilsson²

2014

Acta Orthopaedica

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“…The study was part of a broader study, some of which has been described previously [21][22] . Cases were drawn from a regional Perthes' register.…”

Section: Methodsmentioning

confidence: 99%

A case control study to determine the association between Perthes’ disease and the recalled use of tobacco during pregnancy, and biological markers of current tobacco smoke exposure

Perry

Thomson

Pope

et al. 2017

The Bone & Joint Journal

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Aims It is well established that there is a strong association between Perthes’ disease and worsening socioeconomic deprivation. It has been suggested that the primary determinant driving this association is exposure to tobacco smoke. This study aimed to examine this hypothesis. Patients and Methods A hospital case-control study (n = 149/146) examined the association between tobacco smoke exposure and Perthes’ disease, adjusting for area-level socioeconomic deprivation. Tobacco smoke exposure was assessed by parental questionnaire of smoking habits during pregnancy, and by quantitative assay of current exposure using the urinary cotinine-creatinine ratio, which is a widely used and validated measure of tobacco smoke exposure. Results The odds of Perthes’ disease significantly increased with reported in utero exposure after adjustment for socioeconomic deprivation (maternal smoking odds ratio (OR) 2.06, 95% confidence interval (CI) 1.17 to 3.63; paternal smoking OR 2.09, 95% CI 1.26 to 3.46). The cotinine-creatinine ratio was significantly greater in cases, OR 1.63 (95% CI 1.09 to 2.43), suggesting a greater ‘dose’ of current tobacco exposure. Conclusion An association exists between tobacco smoke exposure and Perthes’ disease but we remain unable to disentangle the association with socioeconomic deprivation. Cite this article: Bone Joint J 2017;99-B:1102–8.

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“…A number of studies have shown a strong association with socioeconomic deprivation in childhood. [2][3][4] Other proposed associations include small stature, 5 dietary deficiencies, 6 passive smoking, 7,8 childhood hyperactivity, 9 white European ancestry, latitude distance from the equator, 10 and an inherited predisposition to abnormal clotting. 11,12 In their early descriptions of LCPD, both Jacques Calvé 13 and Georg Perthes 14 described siblings with the disease.…”

Section: Legg-calvé-perthes Disease (Lcpd)mentioning

confidence: 99%