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[Association of atopic eczema and attention-deficit/hyperactivity disorder - meta-analysis of epidemiologic studies]
Jochen Schmitt1, Christian Apfelbacher, Joachim Heinrich
1Institut und Poliklinik für Arbeits- und Sozialmedizin, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden.
Insights
Children with atopic dermatitis (AD) have a 43% increased risk of attention-deficit/hyperactivity disorder (ADHD). This association between AD and ADHD may be linked to sleep disturbances, warranting further research into underlying mechanisms.
Area of Science:
- Pediatric Health
- Dermatology
- Neurodevelopmental Disorders
Context:
- Atopic dermatitis (AD) and attention-deficit/hyperactivity disorder (ADHD) are common childhood conditions.
- Previous research has suggested a link between atopic diseases and ADHD, but evidence remains inconclusive.
Purpose:
- To investigate the association between atopic dermatitis (AD) and attention-deficit/hyperactivity disorder (ADHD).
- To quantify the strength of this association using meta-analysis of four epidemiological studies, controlling for confounders.
Summary:
- Four epidemiological studies consistently show a positive association between AD and ADHD, independent of environmental factors and other comorbidities.
- Infant AD is particularly linked to later ADHD symptom development, with sleep problems suggested as a contributing factor.
- Children with AD have a 43% increased risk of ADHD diagnosis or symptoms compared to those without AD (pooled OR: 1.43).
Impact:
- Findings highlight a significant comorbidity between AD and ADHD.
- Suggests the need for further investigation into biological mechanisms connecting these conditions.
- Informs the development of targeted therapeutic and preventive strategies for affected children.
Background:
Atopic dermatitis (AD) and attention-deficit/hyperactivity disorder (ADHD) are frequent paediatric conditions with high medical relevance. A possible relationship between atopic diseases (i.e., AD, asthma, and allergic rhinitis) has long been discussed, but convincing evidence is still missing.
Methods:
We investigated the relationship between AD and ADHD in two cross-sectional studies and in two birth cohort studies considering lifestyle factors, environmental factors, and atopic comorbidities as potential confounders. To quantify the strength of association between AD and ADHD, data from the four epidemiologic studies were summarized by means of a meta-analysis. Odds ratios (OR) were pooled for the association between prevalent or previous AD and prevalent ADHD from the four studies adjusted for age, sex, and atopic comorbidity (allergic rhinitis, asthma).
Results:
The epidemiologic studies conducted consistently indicate an association between AD and ADHD which is independent of environmental exposures and other comorbidities. Particularly infant AD appears to be associated with later development of ADHD symptoms. Sleeping problems due to AD are suggested as playing an important role for the observed association between AD and ADHD. The pooled OR (95 % confidence interval (95 %CI)) for the association between AD and ADHD was 1.43 (1.25-1.64).
Discussion:
Four new epidemiologic studies consistently indicate a positive association between AD and ADHD. Compared to children without AD, children with previous or prevalent AD have an approximately 43 % increased risk to be diagnosed with ADHD or to display clinical ADHD symptoms. Following our findings, the biological mechanisms underlying the observed comorbidity between AD and ADHD require further investigation in order to subsequently develop targeted therapeutic and preventive strategies.
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