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Ocular injuries, attention deficit and hyperactivity disorder, and maternal anxiety/depression levels: Is there a
Helin Yilmaz Kafali1, Elif Demirkilinc Biler2, Melis Palamar2
1Department of Child and Adolescent Psychiatry, Ankara City Hospital, Ministry of Health, Ankara, Turkey.
Insights
Attention deficit and hyperactivity disorder (ADHD) is nearly twice as common in children with penetrating eye injuries (PEIs). Maternal anxiety also significantly increased in this group, suggesting a link that warrants further investigation for potential prevention strategies.
Area of Science:
- Ophthalmology
- Child Psychiatry
- Pediatrics
Background:
- Children with attention deficit and hyperactivity disorder (ADHD) face increased accident risks.
- Maternal anxiety and depression are also linked to higher accident rates in children.
- Investigating these comorbidities in pediatric penetrating eye injury (PEI) is crucial.
Purpose of the Study:
- To determine the frequency of ADHD in children who have sustained a PEI.
- To assess the prevalence of maternal anxiety and depression in mothers of children with PEI.
- To explore the association between PEI and these psychiatric conditions.
Main Methods:
- A case-control study involving 79 children (39 with PEI, 40 controls) aged 5-15.
- Ophthalmologic examinations were conducted for all participants.
- Psychiatric diagnoses were assessed using standardized scales (e.g., T-DSM-IV-S) and maternal self-report measures (Beck Depression Scale, STAI).
Main Results:
- ADHD was significantly more frequent in children with PEI (48.7%) compared to controls (17.5%).
- Children with PEI showed higher scores on ADHD symptom scales and maternal anxiety measures.
- Logistic regression indicated a trend towards increased ADHD risk (OR=3.538) in children with PEI.
Conclusions:
- Nearly half of children with PEI were diagnosed with ADHD.
- Maternal anxiety levels were significantly higher in the PEI group.
- Further research into treating ADHD in children and anxiety in mothers may help prevent vision loss from PEI.
Purpose:
Given the increased risk of accidents in patients with attention deficit and hyperactivity disorder (ADHD) or maternal anxiety/depression, we aimed to investigate the frequency of the two diseases in children with penetrating eye injury (PEI).
Methods:
Altogether 79 children, 39 with PEIs and 40 healthy individuals (control group), aged 5-15 years, underwent a complete ophthalmologic examination. Afterwards, schedule for affective disorders and schizophrenia for school-aged children was conducted to assess the psychiatric diagnosis of all children. Turgay diagnostic and statistical manual of mental disorders (DSM-IV)-based child and adolescent behavior disorders screening and rating scale (T-DSM-IV-S) was filled by parents to evaluate the severity of ADHD symptoms. The depression and anxiety levels of mothers of each group were evaluated by two self-report measures: the Beck depression scale and the state-trait anxiety inventory (STAI), respectively. Data were analyzed by IBM SPSS version 22.0. The Chi-square and Fisher's exact test were used to determine whether there is a significant difference between qualitative variables while independent sample t and Mann-Whitney U tests to compare quantitative variables.
Results:
The only diagnostic difference was a significantly higher frequency of ADHD among patients with PEIs (48.7% in PEI vs. 17.5% in control group, χ2 = 7.359, p = 0.007). The total scores of the T-DSM-IV-S (attention subscale U = 418.000, p = 0.006; hyperactivity subscale U = 472.000, p = 0.022) and maternal state-trait anxiety inventory (maternal STAI-state U = 243.000, p = 0.003; maternal STAI-trait U = 298.000, p = 0.021) were significantly higher in the PEI group than in control group. In logistic regression, children with PEI had a tendency to have a 3.5-fold increased risk for ADHD (OR = 3.538, CI = 0.960-13.039, p = 0.058).
Conclusion:
ADHD was detected almost 1 in 2 children with PEIs. Besides, the maternal anxiety level was significantly higher in the PEI group than in the control group. This association should be further explored via a future prospective longitudinal study. Since a proper treatment of ADHD in children and anxiety treatment in mothers may prevent vision loss following PEIs in children.
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