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1.
Adv Exp Med Biol ; 1447: 11-19, 2024.
Article in English | MEDLINE | ID: mdl-38724780

ABSTRACT

Multiple risk factors have been associated with the development of atopic dermatitis (AD). Recent advances in understanding the role of genetics in this disease have been made, with discovery of the filaggrin (FLG) gene as the most notable so far. In addition to FLG gene mutations as a risk factor for AD, a positive family history of atopic or allergic disease in either parent has been shown to confer a greater risk of developing AD. Atopic dermatitis usually presents early in life and is thought to represent the initial step in the "atopic march," which is characterized by the development of other atopic diseases later in life such as asthma, allergic rhinitis, and/or rhinoconjunctivitis, food allergies, and hay fever. Other comorbid diseases that have been associated with AD include increase risk of viral and bacterial skin infections, neuropsychiatric diseases such as attention-deficit hyperactivity disorders (ADHD), and autistic spectrum disorder (ASD). Patients with AD have also been found to have worse sleep quality overall compared to patients without AD. In this chapter, we will discuss the risk factors associated with development of atopic dermatitis as well as the most commonly reported comorbidities in patients with this disease.


Subject(s)
Comorbidity , Dermatitis, Atopic , Filaggrin Proteins , Dermatitis, Atopic/genetics , Dermatitis, Atopic/epidemiology , Humans , Risk Factors , Attention Deficit Disorder with Hyperactivity/genetics , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit Disorder with Hyperactivity/etiology , Genetic Predisposition to Disease , Mutation , Autism Spectrum Disorder/genetics , Autism Spectrum Disorder/epidemiology , Autism Spectrum Disorder/etiology , Intermediate Filament Proteins/genetics
2.
J Am Coll Cardiol ; 83(19): 1870-1882, 2024 May 14.
Article in English | MEDLINE | ID: mdl-38719367

ABSTRACT

BACKGROUND: Incrementing numbers of patients treated for attention-deficit/hyperactivity disorder (ADHD) call for scrutiny concerning long-term drug-safety. OBJECTIVES: This study aims to investigate associations between long-term use of ADHD treatment and cardiovascular outcomes. METHODS: Using nationwide registers, adult patients first-time initiated on ADHD treatment between 1998 and 2020 were identified. Exposure groups were prior users, <1 defined daily dose (DDD) per day, ≥1 DDD per day determined at start of follow-up, and 1 year after patients' first claimed prescription. Outcomes were acute coronary syndromes, stroke, heart failure, and a composite of the above. RESULTS: At start of follow-up, 26,357, 31,211, and 15,696 individuals were correspondingly categorized as prior users (42% female, median age: 30 years [Q1-Q3: 23-41 years]), <1 DDD per day (47% female, median age: 31 years [Q1-Q3: 24-41 years]), and ≥1 DDD per day (47% female, median age: 33 years [Q1-Q3: 25-41 years]), respectively. Comparing ≥1 DDD per day with prior users, elevated standardized 10-year absolute risk of stroke (2.1% [95% CI: 1.8%-2.4%] vs 1.7% [95% CI: 1.5%-1.9%]), heart failure (1.2% [95% CI: 0.9%-1.4%] vs 0.7% [95% CI: 0.6%-0.8%]), and the composite outcome (3.9% [95% CI: 3.4%-4.3%] vs 3.0% [95% CI: 2.8 %-3.2%]) was found-with corresponding risk ratios of 1.2 (95% CI: 1.0-1.5), 1.7 (95% CI: 1.3-2.2), and 1.3 (95% CI: 1.1-1.5). No apparent associations were found for acute coronary syndrome (1.0% [95% CI: 0.8%-1.2%] vs 0.9% [95% CI: 0.8%-1.0%]). CONCLUSIONS: Possible associations between elevated long-term cardiovascular risk and increasing dosage of ADHD treatment use in a young patient group should warrant further investigation.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Cardiovascular Diseases , Humans , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit Disorder with Hyperactivity/drug therapy , Female , Male , Adult , Cardiovascular Diseases/epidemiology , Young Adult , Registries , Middle Aged , Follow-Up Studies , Heart Disease Risk Factors , Central Nervous System Stimulants/adverse effects , Central Nervous System Stimulants/therapeutic use , Time Factors
3.
BMC Health Serv Res ; 24(1): 599, 2024 May 07.
Article in English | MEDLINE | ID: mdl-38715039

ABSTRACT

BACKGROUND: In Mexico, this pioneering research was undertaken to assess the accessibility of timely diagnosis of Dyads [Children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and their primary caregivers] at specialized mental health services. The study was conducted in two phases. The first phase involved designing an "Access Pathway" aimed to identify barriers and facilitators for ADHD diagnosis; several barriers, with only the teacher being identified as a facilitator. In the second phase, the study aimed to determine the time taken for dyads, to obtain a timely diagnosis at each stage of the Access Pathway. As well as identify any disparities based on gender and socioeconomic factors that might affect the age at which children can access a timely diagnosis. METHOD: In a retrospective cohort study, 177 dyads participated. To collect data, the Acceda Survey was used, based on the robust Conceptual Model Levesque, 2013. The survey consisted of 48 questions that were both dichotomous and polytomous allowing the creation of an Access Pathway that included five stages: the age of perception, the age of search, the age of first contact with a mental health professional, the age of arrival at the host hospital, and the age of diagnosis. The data was meticulously analyzed using a comprehensive descriptive approach and a nonparametric multivariate approach by sex, followed by post-hoc Mann-Whitney's U tests. Demographic factors were evaluated using univariable and multivariable Cox regression analyses. RESULTS: 71% of dyads experienced a late, significantly late, or highly late diagnosis of ADHD. Girls were detected one year later than boys. Both boys and girls took a year to seek specialized mental health care and an additional year to receive a formal specialized diagnosis. Children with more siblings had longer delays in diagnosis, while caregivers with formal employment were found to help obtain timely diagnoses. CONCLUSIONS: Our findings suggest starting the Access Pathway where signs and symptoms of ADHD are detected, particularly at school, to prevent children from suffering consequences. Mental health school-based service models have been successfully tested in other latitudes, making them a viable option to shorten the time to obtain a timely diagnosis.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Early Diagnosis , Health Services Accessibility , Mental Health Services , Humans , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/epidemiology , Child , Male , Female , Mexico/epidemiology , Adolescent , Retrospective Studies , Mental Health Services/statistics & numerical data , Socioeconomic Factors
4.
PLoS One ; 19(5): e0299980, 2024.
Article in English | MEDLINE | ID: mdl-38758772

ABSTRACT

BACKGROUND: To fulfil the diagnostic criteria of Attention Deficit Hyperactivity Disorder in the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms should be observed in two or more settings. This implies that diagnostic procedures require observations reported from informants in different settings, such as teachers in school and caregivers at home. This study examined parent-teacher agreement in reporting hyperactivity/inattention and its relationship with child's, parent's, and family's characteristics. METHOD: We used data from the 2004 United Kingdom Mental Health of Children and Young People survey, including 7977 children aged 4-17, to investigate cross-informant agreement between parents and teachers on the hyperactivity-inattention subscale of the Strengths and Difficulties Questionnaire. The characteristics of different patterns of informant agreement were assessed using multinomial logistic regression. RESULTS: Cross-informant agreement of parent and teacher was low (weighted kappa = .34, 95% C.I.: .31, .37). Some characteristics, such as male child and parental emotional distress, were associated with higher likelihood of parent-teacher discrepancy. CONCLUSION: We found low informant agreement in the hyperactive/inattention subscale, as hypothesised and consistent with previous studies. The current study has found several factors that predict discrepancy, which were partly consistent with previous research. Possible explanation, implications, and further research on parent-teacher informant discrepancy in reporting hyperactivity/inattention were discussed.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Parents , School Teachers , Humans , Male , Female , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/epidemiology , Child , United Kingdom/epidemiology , Parents/psychology , Adolescent , School Teachers/psychology , Child, Preschool , Surveys and Questionnaires
5.
BMC Pregnancy Childbirth ; 24(1): 364, 2024 May 15.
Article in English | MEDLINE | ID: mdl-38750437

ABSTRACT

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is one of the more common neuropsychiatric disorders in women of reproductive age. Our objective was to compare perinatal outcomes between women with an ADHD diagnosis and those without. METHODS: A retrospective population-based cohort study utilizing the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS) United States database. The study included all women who either delivered or experienced maternal death from 2004 to 2014. Perinatal outcomes were compared between women with an ICD-9 diagnosis of ADHD and those without. RESULTS: Overall, 9,096,788 women met the inclusion criteria. Amongst them, 10,031 women had a diagnosis of ADHD. Women with ADHD, compared to those without, were more likely to be younger than 25 years of age; white; to smoke tobacco during pregnancy; to use illicit drugs; and to suffer from chronic hypertension, thyroid disorders, and obesity (p < 0.001 for all). Women in the ADHD group, compared to those without, had a higher rate of hypertensive disorders of pregnancy (HDP) (aOR 1.36, 95% CI 1.28-1.45, p < 0.001), cesarean delivery (aOR 1.19, 95% CI 1.13-1.25, p < 0.001), chorioamnionitis (aOR 1.34, 95% CI 1.17-1.52, p < 0.001), and maternal infection (aOR 1.33, 95% CI 1.19-1.5, p < 0.001). Regarding neonatal outcomes, patients with ADHD, compared to those without, had a higher rate of small-for-gestational-age neonate (SGA) (aOR 1.3, 95% CI 1.17-1.43, p < 0.001), and congenital anomalies (aOR 2.77, 95% CI 2.36-3.26, p < 0.001). CONCLUSION: Women with a diagnosis of ADHD had a higher incidence of a myriad of maternal and neonatal complications, including cesarean delivery, HDP, and SGA neonates.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Databases, Factual , Pregnancy Complications , Pregnancy Outcome , Humans , Female , Attention Deficit Disorder with Hyperactivity/epidemiology , Pregnancy , Adult , Retrospective Studies , Pregnancy Complications/epidemiology , Infant, Newborn , Pregnancy Outcome/epidemiology , United States/epidemiology , Young Adult , Cesarean Section/statistics & numerical data , Delivery, Obstetric/statistics & numerical data , Hypertension, Pregnancy-Induced/epidemiology
6.
Article in English | MEDLINE | ID: mdl-38791781

ABSTRACT

(1) Objectives: This study aimed to assess the 5-year prevalence and clinical profile of attention deficit hyperactive disorder (ADHD) among adult patients seeking care in a tertiary care hospital in Oman. (2) Methods: The data were analysed using descriptive and inferential statistics and standardised prevalence estimates were calculated. (3) Results: Of the 39,881 hospital visits, 1.77% were made by adults with ADHD. This is equivalent to 17.8 visits per 1000 outpatients. The year 2021 saw the highest prevalence among the five years considered, while 2020 had the lowest prevalence. Although the age distribution indicated that the age group 'under 20' had the highest prevalence, the gender distribution showed that ADHD was more common among adult men. Among the various subtypes of ADHD, inattention was the most common. (4) Conclusions: This study specifically compared the prevalence and associated factors between an adult cohort with ADHD and those other psychiatric clinic attendees during the same period. The study offers important information on the prevalence and clinical profile of adults with ADHD in the population under consideration.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Tertiary Care Centers , Humans , Attention Deficit Disorder with Hyperactivity/epidemiology , Male , Prevalence , Adult , Female , Oman/epidemiology , Tertiary Care Centers/statistics & numerical data , Young Adult , Middle Aged , Adolescent , Aged
7.
Free Radic Biol Med ; 220: 324-332, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-38704054

ABSTRACT

BACKGROUND: Selenoproteins regulate pathways controlling neurodevelopment, e.g., redox signaling and thyroid hormone metabolism. However, studies investigating maternal selenium in relation to child neurodevelopmental disorders are scarce. METHODS: 719 mother-child pairs from the prospective population-based Odense Child Cohort study in Denmark were included. Three selenium biomarkers, i.e. concentrations of serum selenium, selenoprotein P (SELENOP), and activity of glutathione peroxidase 3 (GPX3), along with serum copper, zinc and iron were measured in early third trimester (at 28.9+/-0.8 weeks of pregnancy). ADHD and ASD traits in children were assessed systematically using the established Child Behaviour Checklist at 5 years of age, based on a Danish reference cohort with cut-off at 90th percentile. Multivariable regression models adjusted for biologically relevant confounders were applied. RESULTS: 155 of 719 (21.6 %) children had ASD traits and 59 of 719 (8.2 %) children had traits of ADHD at 5 years of age. In crude and adjusted models, all three selenium biomarkers associated inversely with ADHD traits. For ADHD, fully adjusted OR for 10 µg/L increment in selenium was 0.76 (95 % CI 0.60, 0.94), for one mg/L increment in SELENOP was 0.73 (0.56, 0.95), and for 10 U/L increment in GPx3 was 0.93 (0.87,1.00). Maternal total selenium was inversely associated with child ASD traits, OR per 10 µg/L increment was 0.85 (0.74, 0,98). SELENOP and GPx3 were not associated with ASD traits. The associations were specific to selenium, as other trace elements such as copper, zinc, or iron were not associated with the outcomes. CONCLUSIONS: The results provide coherent evidence for selenium deficiency as a risk factor for ADHD and ASD traits in an environment with borderline supply, the causality of which should be elucidated in a randomized controlled trial.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Glutathione Peroxidase , Prenatal Exposure Delayed Effects , Selenium , Selenoprotein P , Humans , Selenium/blood , Selenium/deficiency , Female , Attention Deficit Disorder with Hyperactivity/blood , Attention Deficit Disorder with Hyperactivity/epidemiology , Pregnancy , Glutathione Peroxidase/blood , Male , Denmark/epidemiology , Child, Preschool , Prenatal Exposure Delayed Effects/blood , Prenatal Exposure Delayed Effects/epidemiology , Selenoprotein P/blood , Adult , Biomarkers/blood , Prospective Studies , Autistic Disorder/blood , Autistic Disorder/epidemiology , Cohort Studies , Child , Zinc/blood , Zinc/deficiency , Copper/blood
8.
Int J Hyg Environ Health ; 259: 114377, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38692176

ABSTRACT

BACKGROUND: Early-life exposure to phthalates alters behaviors in animals. However, epidemiological evidence on childhood phthalate exposure and attention-deficit/hyperactivity disorder (ADHD) behaviors is limited. METHODS: This study included 243 children from the ReCHARGE (Revisiting Childhood Autism Risks from Genetics and Environment) study, who were previously classified as having autism spectrum disorder (ASD), developmental delay, other early concerns, and typical development in the CHARGE case-control study. Twenty phthalate metabolites were measured in spot urine samples collected from children aged 2-5 years. Parents reported on children's ADHD symptoms at ages 8-18 years using Conners-3 Parent Rating Scale. Covariate-adjusted negative binomial generalized linear models were used to investigate associations between individual phthalate metabolite concentrations and raw scores. Weighted quantile sum (WQS) regression with repeated holdout validation was used to examine mixture effects of phthalate metabolites on behavioral scores. Effect modification by child sex was evaluated. RESULTS: Among 12 phthalate metabolites detected in >75% of the samples, higher mono-2-heptyl phthalate (MHPP) was associated with higher scores on Inattentive (ß per doubling = 0.05, 95% confidence interval [CI]: 0.02, 0.08) and Hyperactive/Impulsive scales (ß = 0.04, 95% CI: 0.00, 0.07), especially among children with ASD. Higher mono-carboxy isooctyl phthalate (MCiOP) was associated with higher Hyperactivity/Impulsivity scores (ß = 0.07, 95% CI: -0.01, 0.15), especially among typically developing children. The associations of the molar sum of high molecular weight (HMW) phthalate metabolites and a phthalate metabolite mixture with Hyperactivity/Impulsivity scores were modified by sex, showing more pronounced adverse associations among females. CONCLUSION: Exposure to phthalates during early childhood may impact ADHD behaviors in middle childhood and adolescence, particularly among females. Although our findings may not be broadly generalizable due to the diverse diagnostic profiles within our study population, our robust findings on sex-specific associations warrant further investigations.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Environmental Exposure , Environmental Pollutants , Phthalic Acids , Humans , Phthalic Acids/urine , Phthalic Acids/toxicity , Attention Deficit Disorder with Hyperactivity/urine , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit Disorder with Hyperactivity/chemically induced , Child , Male , Female , Adolescent , Environmental Pollutants/urine , Child, Preschool , Environmental Exposure/adverse effects , Environmental Exposure/analysis , Case-Control Studies , Autism Spectrum Disorder/urine , Autism Spectrum Disorder/epidemiology
9.
J Neurodev Disord ; 16(1): 26, 2024 May 26.
Article in English | MEDLINE | ID: mdl-38796448

ABSTRACT

BACKGROUND: Synthetic oxytocin (sOT) is frequently administered during parturition. Studies have raised concerns that fetal exposure to sOT may be associated with altered brain development and risk of neurodevelopmental disorders. In a large and diverse sample of children with data about intrapartum sOT exposure and subsequent diagnoses of two prevalent neurodevelopmental disorders, i.e., attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), we tested the following hypotheses: (1) Intrapartum sOT exposure is associated with increased odds of child ADHD or ASD; (2) associations differ across sex; (3) associations between intrapartum sOT exposure and ADHD or ASD are accentuated in offspring of mothers with pre-pregnancy obesity. METHODS: The study sample comprised 12,503 participants from 44 cohort sites included in the Environmental Influences on Child Health Outcomes (ECHO) consortium. Mixed-effects logistic regression analyses were used to estimate the association between intrapartum sOT exposure and offspring ADHD or ASD (in separate models). Maternal obesity (pre-pregnancy BMI ≥ 30 kg/m2) and child sex were evaluated for effect modification. RESULTS: Intrapartum sOT exposure was present in 48% of participants. sOT exposure was not associated with increased odds of ASD (adjusted odds ratio [aOR] 0.86; 95% confidence interval [CI], 0.71-1.03) or ADHD (aOR 0.89; 95% CI, 0.76-1.04). Associations did not differ by child sex. Among mothers with pre-pregnancy obesity, sOT exposure was associated with lower odds of offspring ADHD (aOR 0.72; 95% CI, 0.55-0.96). No association was found among mothers without obesity (aOR 0.97; 95% CI, 0.80-1.18). CONCLUSIONS: In a large, diverse sample, we found no evidence of an association between intrapartum exposure to sOT and odds of ADHD or ASD in either male or female offspring. Contrary to our hypothesis, among mothers with pre-pregnancy obesity, sOT exposure was associated with lower odds of child ADHD diagnosis.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Autism Spectrum Disorder , Body Mass Index , Oxytocin , Prenatal Exposure Delayed Effects , Humans , Female , Pregnancy , Male , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit Disorder with Hyperactivity/etiology , Child , Autism Spectrum Disorder/epidemiology , Autism Spectrum Disorder/etiology , Adult , Obesity, Maternal/epidemiology , Child, Preschool , Cohort Studies , Obesity/epidemiology
10.
J Affect Disord ; 358: 163-174, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-38718944

ABSTRACT

BACKGROUND: Individuals with prenatal alcohol exposure (PAE) commonly experience co-occurring diagnoses, which are often overlooked and misdiagnosed and have detrimental impacts on accessing appropriate services. The prevalence of these co-occurring diagnoses varies widely in the existing literature and has not been examined in PAE without an FASD diagnosis. METHOD: A search was conducted in five databases and the reference sections of three review papers, finding a total of 2180 studies. 57 studies were included in the final analysis with a cumulative sample size of 29,644. Bayesian modeling was used to determine aggregate prevalence rates of co-occurring disorders and analyze potential moderators. RESULTS: 82 % of people with PAE had a co-occurring diagnosis. All disorders had a higher prevalence in individuals with PAE than the general population with attention deficit hyperactivity disorder, learning disorder, and intellectual disability (ID) being the most prevalent. Age, diagnostic status, and sex moderated the prevalence of multiple disorders. LIMITATIONS: While prevalence of disorders is crucial information, it does not provide a direct representation of daily functioning and available supports. Results should be interpreted in collaboration with more individualized research to provide the most comprehensive representation of the experience of individuals with PAE. CONCLUSIONS: Co-occurring diagnoses are extremely prevalent in people with PAE, with older individuals, females, and those diagnosed with FASD being most at risk for having a co-occurring disorder. These findings provide a more rigorous examination of the challenges faced by individuals with PAE than has existed in the literature, providing clinicians with information to ensure early identification and effective treatment of concerns to prevent lifelong challenges.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Comorbidity , Prenatal Exposure Delayed Effects , Humans , Female , Pregnancy , Prevalence , Prenatal Exposure Delayed Effects/epidemiology , Attention Deficit Disorder with Hyperactivity/epidemiology , Fetal Alcohol Spectrum Disorders/epidemiology , Male , Intellectual Disability/epidemiology , Learning Disabilities/epidemiology , Bayes Theorem , Adult , Mental Disorders/epidemiology , Child
11.
Eur Rev Med Pharmacol Sci ; 28(9): 3303-3312, 2024 May.
Article in English | MEDLINE | ID: mdl-38766788

ABSTRACT

OBJECTIVE: The objective of this study was to assess whether individuals with attention deficit hyperactivity disorder (ADHD) exhibit a higher prevalence of traumatic dental injuries (TDIs) compared to those without ADHD through a systematic review and meta-analysis of the existing literature. MATERIALS AND METHODS: A search strategy using the Medical Subject Heading (MeSH) vocabulary was employed for a comprehensive search across various databases, including PubMed, Scopus, Web of Science, Cochrane Library, and Embase. The Joanna Briggs Institute Summary was utilized for data collection. Additionally, quality assessment, meta-analysis, and bias control were conducted to ensure the reliability of the included studies. A meta-analysis was performed to consolidate the findings of the individual studies. RESULTS: The prevalence of TDIs among individuals with ADHD ranged from 9.6% to 68.2%, while in the healthy control group, it ranged from 0.8% to 44.7%. The meta-analysis findings revealed that individuals with ADHD had 1.98 times higher odds (OR = 1.98, ranging from 1.51 to 2.59 with 95% CI) of experiencing TDIs compared to individuals without ADHD. CONCLUSIONS: The findings of this study suggest a significant association between ADHD and an increased risk of TDIs. Individuals with ADHD were found to be nearly twice as likely to experience TDIs compared to those without ADHD. Efforts should not only be directed towards improving the oral health of this vulnerable group of individuals, but also healthcare practitioners need to be provided with opportunities to create awareness and implement preventive measures to mitigate the risk of TDIs among individuals with ADHD.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Tooth Injuries , Humans , Attention Deficit Disorder with Hyperactivity/epidemiology , Prevalence , Tooth Injuries/epidemiology
12.
Nat Med ; 30(5): 1416-1423, 2024 May.
Article in English | MEDLINE | ID: mdl-38589601

ABSTRACT

Previous studies report an association between maternal diabetes mellitus (MDM) and attention-deficit/hyperactivity disorder (ADHD), often overlooking unmeasured confounders such as shared genetics and environmental factors. We therefore conducted a multinational cohort study with linked mother-child pairs data in Hong Kong, New Zealand, Taiwan, Finland, Iceland, Norway and Sweden to evaluate associations between different MDM (any MDM, gestational diabetes mellitus (GDM) and pregestational diabetes mellitus (PGDM)) and ADHD using Cox proportional hazards regression. We included over 3.6 million mother-child pairs between 2001 and 2014 with follow-up until 2020. Children who were born to mothers with any type of diabetes during pregnancy had a higher risk of ADHD than unexposed children (pooled hazard ratio (HR) = 1.16, 95% confidence interval (CI) = 1.08-1.24). Higher risks of ADHD were also observed for both GDM (pooled HR = 1.10, 95% CI = 1.04-1.17) and PGDM (pooled HR = 1.39, 95% CI = 1.25-1.55). However, siblings with discordant exposure to GDM in pregnancy had similar risks of ADHD (pooled HR = 1.05, 95% CI = 0.94-1.17), suggesting potential confounding by unmeasured, shared familial factors. Our findings indicate that there is a small-to-moderate association between MDM and ADHD, whereas the association between GDM and ADHD is unlikely to be causal. This finding contrast with previous studies, which reported substantially higher risk estimates, and underscores the need to reevaluate the precise roles of hyperglycemia and genetic factors in the relationship between MDM and ADHD.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Diabetes, Gestational , Prenatal Exposure Delayed Effects , Humans , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit Disorder with Hyperactivity/genetics , Female , Pregnancy , Diabetes, Gestational/epidemiology , Child , Male , Prenatal Exposure Delayed Effects/epidemiology , Cohort Studies , Adult , Risk Factors , Mothers , Proportional Hazards Models , Taiwan/epidemiology , New Zealand/epidemiology , Hong Kong/epidemiology
13.
Autism Res ; 17(5): 1027-1040, 2024 May.
Article in English | MEDLINE | ID: mdl-38641914

ABSTRACT

An early detection of Neurodevelopmental Disorders (NDDs) is crucial for their prognosis; however, the clinical heterogeneity of some disorders, such as autism spectrum disorder (ASD) or attention-deficit hyperactivity disorder (ADHD) is an obstacle to accurate diagnoses in children. In order to facilitate the screening process, the current study aimed to identify symptom-based clusters among a community-based sample of preschool and school-aged children, using behavioral characteristics reported by teachers. A total of 6894 children were assessed on four key variables: social communication differences, restricted behavior patterns, restless-impulsiveness, and emotional lability (pre-schoolers) or inattention and hyperactivity-impulsivity (school-aged). From these behavioral profiles, four clusters were identified for each age group. A cluster of ASD + ADHD and others including children with no pathology was clearly identified, whereas two other clusters were characterized by subthreshold ASD and/or ADHD symptoms. In the school-age children, the presence of ADHD was consistently observed with ASD patterns. In pre-schoolers, teachers were more proficient at identifying children who received a diagnosis for either ASD and/or ADHD from an early stage. Considering the significance of early detection and intervention of NDDs, teachers' insights are important. Therefore, promptly identifying subthreshold symptoms in children can help to minimize consequences in social and academic functioning.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Autism Spectrum Disorder , School Teachers , Humans , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/epidemiology , Autism Spectrum Disorder/diagnosis , Autism Spectrum Disorder/physiopathology , Male , Female , Child , Cluster Analysis , Child, Preschool , Schools
16.
J Atten Disord ; 28(8): 1242-1251, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38659313

ABSTRACT

OBJECTIVE: To examine the association between late adolescence ADHD and the risk of serious injury in early adulthood. METHOD: A nationwide cohort study utilizing data from the Military Health Examinations Database for potential military recruits (age 16.5-18 years), cross-referenced with the Israeli National Trauma Registry (2008-2020). Individuals with and without ADHD (mild/severe) were compared for early adulthood injury risk using Cox models. RESULTS: This study compared 76,403 participants with mild ADHD (18.76%) and 330,792 without (81.24%), alongside 2,835 severe ADHD participants (1.11%) versus 252,626 without (98.89%). Adjusted hazard ratios for injury-related hospitalization were 1.27 (95% CI [1.17, 1.37]) for mild ADHD and 1.40 (95% CI [1.09, 1.79]) for severe ADHD, compared to non-ADHD. CONCLUSIONS: Adolescents with ADHD, regardless of severity, had a significantly higher risk of hospitalization due to injury that persists into early adulthood, underscoring the importance of recognizing ADHD as an injury risk and incorporating it into injury prevention strategies.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Hospitalization , Wounds and Injuries , Humans , Attention Deficit Disorder with Hyperactivity/epidemiology , Israel/epidemiology , Adolescent , Male , Female , Wounds and Injuries/epidemiology , Cohort Studies , Hospitalization/statistics & numerical data , Young Adult , Military Personnel/statistics & numerical data , Military Personnel/psychology , Adult , Registries , Risk Factors
17.
J Affect Disord ; 356: 483-491, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38640979

ABSTRACT

OBJECTIVES: A reliable, user-friendly, and multidimensional prediction tool can help to identify children at high risk for ADHD and facilitate early recognition and family management of ADHD. We aimed to develop and validate a risk nomogram for ADHD in children aged 3-17 years in the United States based on clinical manifestations and complex environments. METHODS: A total of 141,356 cases were collected for the prediction model. Another 54,444 cases from a new data set were utilized for performing independent external validation. The LASSO regression was used to control possible variables. A final risk nomogram for ADHD was established based on logistic regression, and the discrimination and calibration of the established nomogram were evaluated by bootstrapping with 1000 resamples. RESULTS: A final risk nomogram for ADHD was established based on 13 independent predictors, including behavioral problems, learning disabilities, age, intellectual disabilities, anxiety symptoms, gender, premature birth, maternal age at childbirth, parent-child interaction patterns, etc. The C-index of this model was 0.887 in the training set, and 0.862 in the validation set. Internal and external validation proved that the model was reliable. CONCLUSIONS: A nomogram, a statistical prediction tool that assesses individualized ADHD risk for children is helpful for the early identification of children at high risk for ADHD and the construction of a conceptual model of society-family-school collaborative diagnosis, treatment, and management of ADHD.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Nomograms , Humans , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/epidemiology , Child , Female , Male , Adolescent , Child, Preschool , Risk Factors , Reproducibility of Results , United States , Logistic Models , Risk Assessment/statistics & numerical data
18.
J Affect Disord ; 356: 647-656, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38657774

ABSTRACT

BACKGROUND: Patients with certain psychiatric disorders have increased lung cancer incidence. However, establishing a causal relationship through traditional epidemiological methods poses challenges. METHODS: Available summary statistics of genome-wide association studies of cigarette smoking, lung cancer, and eight psychiatric disorders, including attention deficit/hyperactivity disorder (ADHD), autism, depression, major depressive disorder, bipolar disorder, insomnia, neuroticism, and schizophrenia (range N: 46,350-1,331,010) were leveraged to estimate genetic correlations using Linkage Disequilibrium Score Regression and assess causal effect of each psychiatric disorder on lung cancer using two-sample Mendelian randomization (MR) models, comprising inverse-variance weighted (IVW), weighted median, MR-Egger, pleiotropy residual sum and outlier testing (MR-PRESSO), and a constrained maximum likelihood approach (cML-MR). RESULTS: Significant positive correlations were observed between each psychiatric disorder and both smoking and lung cancer (all FDR < 0.05), except for the correlation between autism and lung cancer. Both univariable and the cML-MA MR analyses demonstrated that liability to schizophrenia, depression, ADHD, or insomnia was associated with an increased risk of overall lung cancer. Genetic liability to insomnia was linked specifically to squamous cell carcinoma (SCC), while genetic liability to ADHD was associated with an elevated risk of both SCC and small cell lung cancer (all P < 0.05). The later was further supported by multivariable MR analyses, which accounted for smoking. LIMITATIONS: Participants were constrained to European ancestry populations. Causal estimates from binary psychiatric disorders may be biased. CONCLUSION: Our findings suggest appropriate management of several psychiatric disorders, particularly ADHD, may potentially reduce the risk of developing lung cancer.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Genome-Wide Association Study , Lung Neoplasms , Mendelian Randomization Analysis , Mental Disorders , Schizophrenia , Humans , Lung Neoplasms/genetics , Lung Neoplasms/epidemiology , Mental Disorders/genetics , Mental Disorders/epidemiology , Schizophrenia/genetics , Schizophrenia/epidemiology , Attention Deficit Disorder with Hyperactivity/genetics , Attention Deficit Disorder with Hyperactivity/epidemiology , Genetic Predisposition to Disease/genetics , Autistic Disorder/genetics , Autistic Disorder/epidemiology , Bipolar Disorder/genetics , Bipolar Disorder/epidemiology , Risk Factors , Sleep Initiation and Maintenance Disorders/genetics , Sleep Initiation and Maintenance Disorders/epidemiology , Depressive Disorder, Major/genetics , Depressive Disorder, Major/epidemiology , Neuroticism , Causality , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/epidemiology , Cigarette Smoking/epidemiology , Cigarette Smoking/genetics , Linkage Disequilibrium
19.
BMC Psychol ; 12(1): 218, 2024 Apr 20.
Article in English | MEDLINE | ID: mdl-38643160

ABSTRACT

BACKGROUND: Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common disorders in school-aged children. Learning disorder (LD) is also one of the most important psychiatric disorders in children, which can often be associated with ADHD. In this study, we sought to compare self-esteem and quality of life in 8 to 12-year-old children with attention deficit/hyperactivity disorder with and without co-occurring learning disorders in order to emphasize the importance of attention and diagnosis in children with ADHD. METHOD: Among the 8- to 12-year-old outpatients referred to the child and adolescent psychiatry clinic of Omid Babol Clinic, 120 children aged 8 to 12 years with attention deficit/hyperactivity disorder whose disease was diagnosed by a child and adolescent psychiatry subspecialist. Among the tools used to collect information was the Colorado Learning Difficulties Questionnaire by Wilcott et al. (CLDQ), five-scale self-esteem test of Pepe et al. (1989) for children and quality-of-life questionnaire for 8-12-year-old children (PedsQL). RESULTS: This study investigated self-esteem and quality of life in children with ADHD (n = 120, 51.7% boys). Children with ADHD and learning disabilities reported significantly lower self-esteem and quality of life compared to those with ADHD alone. CONCLUSION: Considering the relatively high probability of co-occurrence of ADHD and learning disorders, if one of them is diagnosed in a child, it is possible to look for other disorders in the child in order to avoid the more severe negative effects that this co-occurrence can have on the child by diagnosing it as soon as possible.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Learning Disabilities , Male , Child , Adolescent , Humans , Female , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit Disorder with Hyperactivity/diagnosis , Quality of Life/psychology , Learning Disabilities/epidemiology , Self Concept , Surveys and Questionnaires
20.
Saudi Med J ; 45(4): 397-404, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38657995

ABSTRACT

OBJECTIVES: To determine and compare the prevalence of attention deficit hyperactivity disorder (ADHD) symptoms among male and female medical students in the Eastern Province of Saudi Arabia and evaluate the effect of ADHD on the academic performance of the affected medical students. METHODS: This cross-sectional study measured the prevalence of adult ADHD symptoms among medical students in the Eastern Province of Saudi Arabia. A total of 354 Saudi medical students from King Faisal University, Al-Ahsa, and Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, participated in a self-reported questionnaire. The questionnaire was distributed on different social media platforms from December 2021 to April 2022. RESULTS: Among the study participants, 26% exhibited symptoms highly consistent with adult ADHD. Young age (<20 years, p=0.049) and non-marital status (p=0.048) were associated with a higher rate of ADHD symptoms with recorded statistical significance. Additionally, there is no significant association between grade point average and adult ADHD (p=0.560). CONCLUSION: The study demonstrated a higher prevalence of adult ADHD among medical students in the Eastern Province than the reported rates locally and globally. This could be attributed to social and cultural factors, as well as the chosen method for assessing the symptoms of Diagnostic and Statistical Manual items.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Students, Medical , Humans , Attention Deficit Disorder with Hyperactivity/epidemiology , Saudi Arabia/epidemiology , Students, Medical/statistics & numerical data , Male , Female , Prevalence , Cross-Sectional Studies , Young Adult , Adult , Surveys and Questionnaires , Academic Performance/statistics & numerical data , Age Factors , Self Report
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