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Prevalence of attention-deficit/hyperactivity disorder in patients with pediatric allergic disorders: a nationwide,
Ching-Shan Shyu1, Heng-Kuei Lin, Ching-Heng Lin
1Division of Immunology and Nephrology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung City, Taiwan.
Insights
Pediatric patients with allergic disorders, particularly allergic rhinitis (AR), show a significantly higher risk of developing attention-deficit/hyperactivity disorder (ADHD). Comorbid allergic conditions further elevate this risk, highlighting a critical link between allergies and ADHD in children.
Area of Science:
- Pediatric Allergy and Immunology
- Child Psychiatry
- Epidemiology
Background:
- Allergic disorders like asthma, rhinitis, and dermatitis are prevalent chronic conditions in children.
- These conditions can disrupt sleep, leading to symptoms mimicking attention-deficit/hyperactivity disorder (ADHD).
- Existing research on the ADHD-allergy link is conflicting, necessitating further investigation.
Purpose of the Study:
- To investigate the prevalence of allergic disorders and ADHD in a pediatric population.
- To determine the risk of developing ADHD among children with allergic conditions.
- To identify specific allergic disorders and comorbidities associated with increased ADHD risk.
Main Methods:
- A nationwide, population-based study utilizing Taiwan's National Health Insurance Research Database.
- Inclusion of 226,550 pediatric patients under 18 years old from 2005 data.
- Analysis involved calculating period prevalence rates and employing multivariable logistic regression for risk factor identification.
Main Results:
- In 2005, 21.5% of pediatric patients had allergic disorders, and 0.6% had ADHD.
- Pediatric patients with allergic disorders exhibited a significantly higher prevalence and odds ratio for developing ADHD (p < 0.001).
- Allergic rhinitis (AR) and bronchial asthma (BA), but not atopic dermatitis (AD), were identified as risk factors for ADHD. Comorbidities involving AR substantially increased ADHD risk.
Conclusions:
- Allergic disorders are associated with an increased risk of ADHD in pediatric patients.
- Allergic rhinitis (AR) is the primary contributing allergic condition to ADHD risk.
- Comorbid allergic conditions, especially in conjunction with AR, further elevate the risk of ADHD in children.
Background:
Allergic disorders are common, chronic conditions in pediatric populations. The characteristic symptoms of allergic disorders mainly include bronchial asthma (BA), allergic rhinitis (AR), and atopic dermatitis (AD), all of which may disturb sleep, leading to daytime inattention, irritability, and hyperactivity, which are also components of attention-deficit/hyperactivity disorder (ADHD). Conflicting data exist in the literature regarding the relationship between ADHD and allergic disorders. The aim of this nationwide, population-based study is to examine the prevalence and risk of developing ADHD among allergic patients in a pediatric group.
Methods:
Data from a total of 226,550 pediatric patients under 18 years of age were collected from Taiwan's National Health Insurance Research Database recorded from January 1 to December 31, 2005 and analyzed. We calculated the prevalence of allergic diseases based on various demographic variables, including ADHD. We also used multivariable logistic regression to analyze the risk factors of ADHD.
Results:
In 2005, the period prevalence rates of allergic disorders and ADHD in persons under the age of 18 were 21.5% and 0.6%, respectively. Pediatric patients with allergic disorder(s) had a substantially increased rate of developing ADHD (p < 0.001) in terms of period prevalence and odds ratio (OR). This significance existed across various demographic groups regardless of age, gender, location, or degree of urbanization of their residence. BA and AR, but not AD, were determined to be risk factors for ADHD. Co-morbidities of allergic disorders, including AR+AD, AR+BA and AR+BA+AD, but not BA+AD, were also determined to increase the risk of ADHD.
Conclusion:
Allergic disorders appear to increase the risk of ADHD in pediatric patients. Our detailed analysis shows that the main contributing factor is AR. Co-morbidity with AD, BA, and BA+AD in AR patients further increases the risk of ADHD.
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