Attention-deficit hyperactivity disorder increases the risk of deliberate self-poisoning: A population-based cohort

AbstractBackgroundChildren with attention-deficit hyperactivity disorder (ADHD) may suffer marked impairment in early adulthood, increasing their risk for serious self-harmful behaviors. Deliberate self-poisoning (DSP) is the most common form of deliberate self-harm. An association may exist between ADHD diagnosis and subsequent DSP events. The purpose of study was to determine whether children and adolescents with ADHD are at a greater risk for DSP than are age-matched controls.MethodsClaims data from the Taiwan National Health Insurance Database were used to conduct a retrospective cohort analysis of emergency department visits. The study cohort contained 3685 patients with ADHD (< 8 years old). Each ADHD patient was frequency matched based on sex, age, urbanization, parental occupation, and index year to 10 control patients without ADHD. A Cox proportional-hazards regression model was used to estimate the risk of DSP in the ADHD and comparison cohorts.ResultsThe risk of developing DSP was significantly higher in the ADHD cohort than in the comparison cohort (P < .0001 for log-rank test). After adjusting for potential confounders, the regression model showed that the ADHD patients were at a 4.65-fold greater risk of developing DSP than the control patients were (HR = 4.65, 95% CI: 2.41–8.94).ConclusionChildren with ADHD are at greater risk of developing DSP. Identifying risk factors of DSP is crucial efforts to implement prevention strategies. The identification of the underlying cause of increased DSP among ADHD patients warrants further investigation.

Download Full-text

Characteristics of psychiatric emergency department use among privately insured adolescents with autism spectrum disorder

Autism ◽

10.1177/1362361317749951 ◽

2018 ◽

Vol 23 (3) ◽

pp. 566-573 ◽

Cited By ~ 4

Author(s):

Luther G Kalb ◽

Elizabeth A Stuart ◽

Roma A Vasa

Keyword(s):

Autism Spectrum Disorder ◽

Emergency Department ◽

Attention Deficit Hyperactivity Disorder ◽

Emergency Department Visit ◽

Attention Deficit ◽

Autism Spectrum ◽

Emergency Department Visits ◽

Spectrum Disorder ◽

Hyperactivity Disorder ◽

Adolescents With Autism

This study examined differences in the rates of psychiatric-related emergency department visits among adolescents with autism spectrum disorder, adolescents with attention deficit hyperactivity disorder, and adolescents without autism spectrum disorder or attention deficit hyperactivity disorder. Additional outcomes included emergency department recidivism, probability of psychiatric hospitalization after the emergency department visit, and receipt of outpatient mental health services before and after the emergency department visit. Data came from privately insured adolescents, aged 12–17 years, with autism spectrum disorder (N = 46,323), attention deficit hyperactivity disorder (N = 408,066), and neither diagnosis (N = 2,330,332), enrolled in the 2010–2013 MarketScan Commercial Claims Database. Adolescents with autism spectrum disorder had an increased rate of psychiatric emergency department visits compared to adolescents with attention deficit hyperactivity disorder (IRR = 2.0, 95% confidence interval: 1.9, 2.1) and adolescents with neither diagnosis (IRR = 9.9, 95% confidence interval: 9.4, 10.4). Compared to the other groups, adolescents with autism spectrum disorder also had an increased probability of emergency department recidivism, psychiatric hospitalization after the emergency department visit, and receipt of outpatient care before and after the visit (all p < 0.001). Further research is required to understand whether these findings extend to youth with other neurodevelopmental disorders, particularly those who are publicly insured.

Download Full-text

Quantitative Analysis of Movements in Children with Attention-Deficit Hyperactivity Disorder Using a Smart Watch at School

Applied Sciences ◽

10.3390/app10124116 ◽

2020 ◽

Vol 10 (12) ◽

pp. 4116

Author(s):

Lung-Chang Lin ◽

Chen-Sen Ouyang ◽

Ching-Tai Chiang ◽

Rong-Ching Wu ◽

Rei-Cheng Yang

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Study Data ◽

Study Cohort ◽

Zero Crossing ◽

Children With Adhd ◽

Hyperactivity Disorder ◽

Promising Tool ◽

Smart Watch ◽

Average Variance

Attention-deficit hyperactivity disorder (ADHD) is primarily diagnosed using set criteria and checklists. However, authors have indicated that such criteria and checklists are subjective. In this study, data from the gyroscope and accelerometer in a smart watch were used to analyze the movements of children with ADHD. This study cohort comprised 15 children with ADHD and 15 age- and sex-matched control participants. The children with ADHD and controls wore the watches on their non-writing hands simultaneously in class. The recordings of one patient and one control were tracked for 2 h daily for three consecutive days with desk and seated class activities. We compared the measurements of variance and the zero-crossing rate (ZCR) of the gyroscope and accelerometer between the children with ADHD and controls. All average variance and ZCR values of the three axes (x, y, and z) in the gyroscope and accelerometer were higher in children with ADHD than in the controls. Significant differences in average variance values on the y-axis (p < 0.001) and ZCR values on all three axes (x, p = 0.005; y, p = 0.003; and z, p = 0.004) of the gyroscope were observed. Similarly, significant differences in the average variance values on the three axes (x, p = 0.001; y, p < 0.001; and z, p < 0.001) and ZCR values on the z-axis (p = 0.006) of the accelerometer were observed. The proposed method is a promising tool to objectively analyze the movements of children with ADHD at school.

Download Full-text

The Association of Prenatal Tetanus, Diphtheria, and Acellular Pertussis (Tdap) Vaccination With Attention-Deficit/Hyperactivity Disorder

American Journal of Epidemiology ◽

10.1093/aje/kwaa074 ◽

2020 ◽

Vol 189 (10) ◽

pp. 1163-1172

Author(s):

Tracy A Becerra-Culqui ◽

Darios Getahun ◽

Vicki Chiu ◽

Lina S Sy ◽

Hung Fu Tseng

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Confidence Interval ◽

Attention Deficit ◽

Proportional Hazards ◽

International Classification Of Diseases ◽

Cox Proportional Hazards ◽

Hazard Ratio ◽

Kaiser Permanente ◽

Hyperactivity Disorder ◽

Cox Proportional Hazards Models

Abstract As prenatal vaccinations become more prevalent, it is important to assess potential safety events. In a retrospective cohort study of Kaiser Permanente Southern California (Pasadena, California) mother-child pairs with birth dates during January 1, 2011–December 31, 2014, we investigated the association between prenatal tetanus, diphtheria, and acellular pertussis (Tdap) vaccination and risk of attention-deficit/hyperactivity disorder (ADHD) in offspring. Information on Tdap vaccination during pregnancy was obtained from electronic medical records. ADHD was defined by International Classification of Diseases codes (Ninth or Tenth Revision) and dispensed ADHD medication after age 3 years. Children were followed to the date of their first ADHD diagnosis, the end of Kaiser Permanente membership, or the end of follow-up (December 31, 2018). In Cox proportional hazards models, we estimated unadjusted and adjusted hazard ratios for the association between maternal Tdap vaccination and ADHD, with inverse probability of treatment weighting (IPTW) used to adjust for confounding. Of 128,756 eligible mother-child pairs, 85,607 were included in the final sample. The ADHD incidence rate was 3.41 per 1,000 person-years in the Tdap-vaccinated women and 3.93 per 1,000 person-years in the unvaccinated (hazard ratio = 1.01, 95% confidence interval: 0.88, 1.16). The IPTW-adjusted analyses showed no association between prenatal Tdap vaccination and ADHD in offspring (hazard ratio = 1.00, 95% confidence interval: 0.88, 1.14). In this study, prenatal Tdap vaccination was not associated with ADHD risk in offspring, supporting recommendations to vaccinate pregnant women.

Download Full-text

Incidence of Attention Deficit Hyperactivity Disorder (ADHD) Diagnoses in Navarre (Spain) from 2003 to 2019

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18179208 ◽

2021 ◽

Vol 18 (17) ◽

pp. 9208

Author(s):

Leire Leache ◽

Olast Arrizibita ◽

Marta Gutiérrez-Valencia ◽

Luis Carlos Saiz ◽

Juan Erviti ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Incidence Rate ◽

Attention Deficit ◽

Seasonal Pattern ◽

Cohort Analysis ◽

Compulsory Education ◽

Population Based ◽

Childhood And Adolescence ◽

Similar Time ◽

Hyperactivity Disorder

(1) Background: Attention deficit hyperactivity disorder (ADHD) constitutes one of the leading mental health and behavioral disorders in childhood and adolescence. The main objective of this study was to analyze the time trend in the incidence of ADHD diagnoses in Navarre (Spain) from 2003 to 2019 in children and adolescents from 5 to 19 years old. Additionally, the seasonal trends of ADHD incidence and ADHD prevalence were determined. (2) Methods: A population-based observational retrospective study, which included people born between 1991 and 2011 and who attended compulsory education between 2007 and 2017 in Navarre (Spain), was carried out with data from both the Education and Health Department databases. (3) Results: The incidence rate increased from 4.18 cases per 1000 person-years in 2003 to 7.43 cases per 1000 person-years in 2009, before decreasing progressively to 2.1 cases per 1000 person-years in 2019. A peak incidence rate at 7–8 years of age was observed, which is consistent across the study period and for both genders. Males were more than twice as likely to be diagnosed with ADHD than females, with similar time trends in both. A seasonal pattern in ADHD diagnosis was found, with peaks in February–March and the lowest rates in the summer months. Inattentive cases were much more frequent than hyperactive cases, whereas combined cases remained low across the study period. (4) Conclusions: In this age-period-cohort analysis, a clear period and age effect was observed. We found a decreasing trend in the ADHD incidence rate since 2015. Further research is needed to confirm whether a change of trend is occurring globally.

Download Full-text

The association between thyroid function biomarkers and attention deficit hyperactivity disorder

Scientific Reports ◽

10.1038/s41598-020-75228-w ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Diana Albrecht ◽

Till Ittermann ◽

Michael Thamm ◽

Hans-Jörgen Grabe ◽

Martin Bahls ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Children And Adolescents ◽

Thyroid Function ◽

Attention Deficit ◽

Study Cohort ◽

Adhd Symptoms ◽

Free Triiodothyronine ◽

Significant Positive Association ◽

Adhd Diagnosis ◽

Hyperactivity Disorder

Abstract The relation between thyroid function biomarkers and attention deficit hyperactivity disorder (ADHD) in children and adolescents is currently unclear. Cross-sectional data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Baseline) was analyzed to assess the association between thyroid function biomarkers and ADHD in a population-based, nationally representative sample. The study cohort included 11,588 children and adolescents with 572 and 559 having an ADHD diagnosis or symptoms, respectively. ADHD symptoms were assessed through the Inattention/Hyperactivity subscale of the Strength and Difficulties Questionnaire. ADHD diagnosis was determined by a physician or psychologist. Serum thyroid stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) concentrations were determined enzymatically. Adjusted regression models were used to relate serum TSH, fT3, and fT4 with risk for ADHD diagnosis or symptoms. In children, a 1 mIU/l higher TSH was related to a 10% lower risk (odds ratio [OR] 0.90; 95% confidence interval [CI] 0.81–1.00) of ADHD diagnosis. We found a significant positive association between fT3 and continuously assessed ADHD symptoms in children (β 0.08; 95% CI 0.03–0.14). Our results suggest that physical maturity may influence the association between thyroid function biomarkers and risk for ADHD.

Download Full-text

Increased Risk of Traumatic Injuries Among Parents of Children with Attention Deficit/Hyperactivity Disorder: A Nationwide Population-Based Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073586 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3586

Author(s):

Dian-Jeng Li ◽

Yi-Lung Chen ◽

Ying-Yeh Chen ◽

Ray C. Hsiao ◽

Wei-Hsin Lu ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Attention Deficit Hyperactivity Disorder ◽

Brain Injury ◽

Attention Deficit ◽

Burn Injury ◽

Cox Proportional Hazards ◽

Traumatic Injuries ◽

Children With Adhd ◽

Hyperactivity Disorder ◽

Increased Risk

Children with attention deficit/hyperactivity disorder (ADHD) are vulnerable to traumatic injuries. Parents of children with ADHD experience undesirable impacts more frequently than parents of children without ADHD. The aim of this study was to evaluate whether traumatic injuries are more prevalent in parents of children with ADHD than in parents of children without ADHD. We compared the prevalence of traumatic injuries between parents of children with and without ADHD by using data from the Taiwan Maternal and Child Health Database from 2004 to 2017. The Cox proportional-hazards regression model was used to examine differences in burn injury, fracture, and traumatic brain injury between parents of children with and without ADHD after adjustment for age, urbanicity, and income level. In total, 81,401 fathers and 87,549 mothers who had at least one offspring with ADHD and 1,646,100 fathers and 1,730,941 mothers with no offspring with ADHD were included in the analysis. The results indicated that both fathers and mothers of children with ADHD had higher risks of burn injury, fracture, and traumatic brain injury than fathers and mothers of children without ADHD. Mothers of children with ADHD had higher risks for all kinds of traumatic events than fathers of children with ADHD.

Download Full-text

Paternal Smoking During Early Developmental Period and Risk of Offspring's Attention Deficit Hyperactivity Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2206 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S220-S220

Author(s):

H.S. Kim ◽

W.S. Yang ◽

C.H. Lee ◽

Y.R. Bang ◽

J.H. Yoo ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Regression Model ◽

Attention Deficit ◽

Multivariate Logistic Regression Analysis ◽

Developmental Period ◽

Hyperactivity Disorder ◽

Increased Risk ◽

One Year ◽

Early Developmental ◽

Paternal Smoking

IntroductionAlthough prenatal maternal smoking is an established risk factor for offspring's attention deficit hyperactivity disorder (ADHD), the studies of association between paternal smoking and childhood ADHD have produced inconsistent results.ObjectiveThe objective of the present study was to determine whether paternal smoking during early developmental period is associated with an increased risk of offspring's ADHD.MethodsWe conducted hospital-based case-control study with 107 medically diagnosed ADHD cases and 205 controls (aged 6–12 years). The diagnoses of ADHD were assessed with DSM-IV based semi-structured diagnostic interviews. Paternal smoking behavior was assessed with spouse-report questionnaire. The association between exposure to paternal smoking and ADHD were analyzed using multivariate logistic regression analysis. The primary outcome of interest was an odds ratio (ORs) reflecting the risk of offspring's ADHD incidence associated with father's smoking during the index pregnancy, up to one year after birth, and current smoking status. Control variables in our regression model were age, sex, financial status, parents’ education levels, low birth weight, and premature birth.ResultsOur final regression model revealed that paternal smoking during pregnancy (OR = 1.68, 95% CI = 1.03–2.76) and up to one year after birth (OR = 1.69, 95% CI = 1.04–2.77) were significantly related to their offspring's ADHD.ConclusionsThe current results suggest that exposure to paternal smoking during the fetal and newborn period is associated with increased risk of ADHD. This study warrants public health policies to reduce children's exposure to secondhand smoke and their risk of ADHD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

Association of Attention deficit hyperactivity disorder and Kawasaki disease: a nationwide population-based cohort study

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796015000840 ◽

2015 ◽

Vol 25 (6) ◽

pp. 573-580 ◽

Cited By ~ 2

Author(s):

H.-C. Kuo ◽

W.-C. Chang ◽

L.-J. Wang ◽

S.-C. Li ◽

W.-P. Chang

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Kawasaki Disease ◽

Attention Deficit ◽

Survival Rates ◽

Population Based ◽

Study Cohort ◽

Hyperactivity Disorder ◽

Increased Risk ◽

Comparison Cohort ◽

Cox Proportional Hazard Regression

Aims.The association between Kawasaki disease (KD) and Attention deficit hyperactivity disorder (ADHD) has rarely been studied. In this study, we investigated the hypothesis that KD may increase the risk of ADHD using a nationwide Taiwanese population-based claims database.Methods.Our study cohort consisted of patients who were diagnosed with KD between January 1997 and December 2005 (N = 651). For a comparison cohort, five age- and gender-matched control patients for every patient in the study cohort were selected using random sampling (N = 3255). The cumulative incidence of ADHD was 3.89/1000 (from 0.05 to 0.85) in this study. All subjects were tracked for 5 years from the date of cohort entry to identify whether or not they had developed ADHD. Cox proportional hazard regression analysis was performed to evaluate 5-year ADHD-free survival rates.Results.Of all patients, 83 (2.1%) developed ADHD during the 5-year follow-up period, of whom 21 (3.2%) had KD and 62 (1.9%) were in the comparison cohort. The patients with KD seemed to be at an increased risk of developing ADHD (crude hazard ratio (HR): 1.71; 95% confidence interval (CI) = 1.04–2.80; p < 0.05). However, after adjusting for gender, age, asthma, allergic rhinitis, atopic dermatitis and meningitis, the adjusted hazard ratios (AHR) of the ADHD in patients with KD showed no association with the controls (AHR: 1.59; 95% CI = 0.96–2.62; p = 0.07). We also investigated whether or not KD was a gender-dependent risk factor for ADHD, and found that male patients with KD did not have an increased risk of ADHD (AHR: 1.62; 95% CI = 0.96–2.74; p = 0.07) compared with the female patients.Conclusions.The findings of this population-based study suggest that patients with KD may not have an increased risk of ADHD and whether or not there is an association between KD and ADHD remains uncertain.

Download Full-text