Relative Age and Attention-Deficit/Hyperactivity Disorder: Data From Three Epidemiological Cohorts and a Meta-analysis

Caye, Arthur; Benetti, Sílvia Pereira da Cruz; Barros, Aluísio J. D.; Bressan, Rodrigo Affonseca; Gadelha, Ary; Gonçalves, Helen; Manfro, Arthur Gus; Matijasevich, Alícia; Menezes, Ana Maria Baptista; Miguel, Euripides C.; Munhoz, Tiago N.; Pan, Pedro Mário; Salum, Giovanni Abrahão; Santos, Iná S.; Kieling, Christian; Rohde, Luís Augusto

doi:10.1016/j.jaac.2019.07.939

Cited by 31 publications

(33 citation statements)

References 32 publications

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“…Then, we developed a directed acyclic graph (eFigure in the Supplement), informed by the existing literature and expert knowledge, to select a minimally sufficient set of covariates. 21 The following variables were retained as confounders in multivariable regression models: children's age, 22,23 children's sex, 24,25 parental education level, 26,27 household income level, 26,27 type of home district, 26,27 and dog ownership. 28…”

Section: Confoundersmentioning

confidence: 99%

Association Between Greenness Surrounding Schools and Kindergartens and Attention-Deficit/Hyperactivity Disorder in Children in China

et al. 2019

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IMPORTANCE Few studies have investigated the association between greenness and childhood attention-deficit/hyperactivity disorder (ADHD). OBJECTIVE To evaluate the association between greenness surrounding schools or kindergartens and symptoms of ADHD in children. DESIGN, SETTING, AND PARTICIPANTS This population-based cross-sectional study was performed between April 2012 and January 2013 in 7 cities in northeastern China. This analysis included 59 754 children (aged 2-17 years) from 94 schools and kindergartens, who had resided in the study area for 2 years or longer. Data were analyzed from April 15, 2019, to October 10, 2019. EXPOSURES Greenness surrounding each child's school or kindergarten was estimated using 2 satellite image-derived vegetation indexes: the normalized difference vegetation index and the soiladjusted vegetation index. MAIN OUTCOMES AND MEASURES Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) scales were used to measure ADHD symptoms (9 inattention symptoms and 9 hyperactivityimpulsivity symptoms). Parents or guardians rated the frequency of each of 18 ADHD symptoms during the preceding 6 months. Children with 6 or more symptoms of either inattention or hyperactivity-impulsivity were defined as having ADHD symptoms. Generalized linear mixed models were applied to estimate the association between greenness and ADHD symptoms. RESULTS The mean (SD) age of the 59 754 study participants was 10.3 (3.6) years, and 29 494 (49.4%) were girls. A total of 2566 participants (4.3%) had ADHD symptoms. Greenness levels differed substantially across schools and kindergartens. The normalized difference vegetation index within 500 m of a school or kindergarten ranged from −0.09 to 0.77. Greater greenness levels were associated with lower odds of ADHD symptoms. In covariate-adjusted models, a 0.1-unit increase in normalized difference vegetation index or soil-adjusted vegetation index within 500 m of a school or kindergarten was significantly associated with lower odds of ADHD symptoms (odds ratios, 0.87 [95% CI, 0.83-0.91] and 0.80 [95% CI, 0.74-0.86], respectively; P < .001 for both). The associations were robust in a series of sensitivity analyses. CONCLUSIONS AND RELEVANCE These findings suggest that there may be a beneficial association between school-based greenness and ADHD symptoms in Chinese children. Future longitudinal and mechanistic studies are needed to confirm the findings of this cross-sectional analysis and further explore potential mechanisms of this association.

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Section: Confoundersmentioning

confidence: 99%

Association Between Greenness Surrounding Schools and Kindergartens and Attention-Deficit/Hyperactivity Disorder in Children in China

et al. 2019

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“…One of the reasons why the grades 1–3 group is larger than other grades in the psychiatric outpatient clinic may be because the group has a higher diagnosis and treatment rate of ADHD patients [ 7 ]. From three population-based cohorts and a meta-analysis, it is evident that children and adolescents who are relatively younger than their classmates have a higher risk of receiving an ADHD diagnosis [ 22 ]. According to the Center for Disease Control and Prevention in the United States, ADHD was the most frequent mental disorder among children under the age of 18 [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Trends of Mental Disorders and Treatment Continuity Predictors of New Patients in the Paediatric Psychiatry Clinic of a University Hospital

Lee

Bahn

2021

IJERPH

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This study analysed trends of first-time patients visiting the paediatric psychiatry clinic in a university hospital. The medical records from 2009 to 2016 of first-time patients visiting the Kyung Hee University Hospital were reviewed, focusing on children in grades 1–12. We analysed the clinical diagnosis rate of mental disorders per 100,000 in the general population by gender and grade, and the characteristics of patients who sought outpatient care more than three times. The study included 1467 participants, of which 931 were males (63.5%). The number of male patients per 100,000 population significantly decreased from 4.14 in 2009 to 2.03 in 2016. While hyperkinetic disorders had the highest prevalence in males, neurotic disorders were most frequent in females. The rate of disruptive behaviour disorders in males and mental retardation in females decreased significantly during the data collecting period. The factors affecting treatment continuity were being female, 7th–12th graders, and diagnosis of depressive, hyperkinetic, and tic disorders. Physicians should consider the new paediatric patients’ gender, grade, and expected diagnosis from their first visit to improve treatment compliance.

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“…One of the reasons why the grades 1-3 group is larger than other grades in the psychiatric outpatient clinic may be because the group has a higher diagnosis and treatment rate of ADHD patients [8]. From three population-based cohorts and a meta-analysis, it is evident that children and adolescents who are relatively younger than their classmates have a higher risk of receiving an ADHD diagnosis [24].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Diagnosis and Treatment Continuity Predictors of New Patients in a Paediatric Psychiatry Clinic

Ar¹,

Bahn²

2021

Preprint

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This study analysed trends of first-time patients visiting the paediatric psychiatry clinic in a university hospital. The medical records from 2009 to 2016 of first-time patients visiting the Kyung Hee university hospital were reviewed, focusing on children in grades 1–12. We analysed the prevalence rate of psychiatric disorders per 100,000 general populations by gender and grade, and the characteristics of patients who sought outpatient care more than three times. The study included 1,467 participants, of which 931 were males (63.5%). The number of male patients per 100,000 populations significantly decreased from 4.14 in 2009 to 2.03 in 2016. While hyperkinetic disorders had the highest prevalence in males, neurotic disorders were most frequent in females. Prevalence of disruptive behaviour disorders in males and mental retardations in females decreased significantly during the study period. The factors affecting continuity were being female, studying in grades 7–12, and diagnosis of depressive, hyperkinetic, and tic disorders. Physicians should consider the new paediatric patients’ gender, grade, and expected diagnosis from their first visit to improve treatment compliance.

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Relative Age and Attention-Deficit/Hyperactivity Disorder: Data From Three Epidemiological Cohorts and a Meta-analysis

Cited by 31 publications

References 32 publications

Association Between Greenness Surrounding Schools and Kindergartens and Attention-Deficit/Hyperactivity Disorder in Children in China

Association Between Greenness Surrounding Schools and Kindergartens and Attention-Deficit/Hyperactivity Disorder in Children in China

Trends of Mental Disorders and Treatment Continuity Predictors of New Patients in the Paediatric Psychiatry Clinic of a University Hospital

Prevalence of Diagnosis and Treatment Continuity Predictors of New Patients in a Paediatric Psychiatry Clinic

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