Relationship between extremity fractures and attention-deficit/hyperactivity disorder symptomatology in adults

Recent studies showed that attention deficit hyperactivity disorder (ADHD) is a lifelong disorder which may be seen in adults as well as children. However, information about the relationship between ADHD and general medical conditions in adulthood is limited. This case-control study aims to determine whether ADHD symptoms are associated with extremity fractures and their clinical characteristics.

Forty patients (25 male and 15 female; aged 18-50 years) who were seen due to extremity fractures and 40 control subjects were enrolled. Childhood and present ADHD symptoms of the participants were assessed using Wender Utah Rating Scale (WURS) and Adult ADHD Self-Report Scale (ASRS), respectively. Trauma type, reason of the trauma, fracture localization, hospitalization requirement, treatment type, and history of previous fracture(s) of the patients were recorded.

Total score and all subscale scores of WURS were higher in the fracture groups compared with controls. Patients also had higher ASRS total score and ASRS hyperactivity-impulsivity subscore than the controls did. WURS irritability, inattentiveness, and behavioral problems/impulsiveness subscore and total score were positively correlated with the history of previous fracture. The patients in whom the reason for the fracture was fighting were also showed higher WURS irritability subscore.

Our results suggest that extremity fractures are associated with ADHD symptoms in adults. These findings may provide an insight into better understanding the lifelong negative impact of ADHD on the physical health of its sufferer.