Assessing the Impact of Serum Ferritin on Life Skills in Children with ADHD

Background/Objectives: This study aimed to investigate the association between serum ferritin levels and functional impairment in children with Attention Deficit Hyperactivity Disorder (ADHD). In addition, we investigated whether this relationship remained significant after controlling for core symptom severity and examined the correlations between ferritin levels and ADHD symptom levels. Methods: The sample included 88 children aged 6-13 years: 44 diagnosed with ADHD and 44 healthy controls (HCs) matched for age and sex. ADHD symptom severity was assessed using Turgay's DSM-IV-Based ADHD and Disruptive Behavior Disorders Screening Scale (T-DSM-IV-S; parent-report) and the Clinical Global Impression-Severity (CGI-S) scale (clinician-rated). Functional impairment was measured using the Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P). Serum ferritin levels were determined through venous blood samples. Statistical analyses included group comparisons, Spearman correlations, and partial correlations controlling for symptom severity. Results: Children with ADHD had significantly lower serum ferritin levels and higher levels of both symptom severity and functional impairment compared to HCs. Ferritin levels were negatively correlated with ADHD symptom severity and with functional impairment in the Life Skills domain. However, after controlling for ADHD symptom severity, the association with Life Skills was no longer statistically significant. Conclusions: Ferritin levels were found to be associated with both ADHD symptom severity and functional impairment in the Life Skills domain. However, this relationship was not independent of symptom severity, suggesting that core ADHD symptoms may mediate the impact of iron status on daily functioning. Due to the study's limitations (e.g., cross-sectional design, small sample size, gender imbalance, and lack of inflammatory and dietary data), our findings should be interpreted with caution, as they do not establish causality or resolve the ongoing inconsistencies in the literature. These results underscore the relevance of iron metabolism in the clinical presentation of ADHD and highlight the need for future research to determine whether improving iron status could serve as an adjunctive strategy in the management of functional impairments in this population.