Risk of mild head injury in preschool children: relationship to attention deficit hyperactivity disorder symptoms

Altun, Hatice; Altun, İdiris

doi:10.1007/s00381-018-3808-8

Cited by 6 publications

(4 citation statements)

References 50 publications

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“…Consistent with findings in the current study, previous research has observed an increased rate of injury among ADHD cases [17][18][19][20][21][22]. We observed that this increased rate occurred in each injury classification considered, especially poisoning.…”

Section: Discussionsupporting

confidence: 92%

“…Research has shown that ADHD is positively associated with emergency services, hospitalization, and healthcare claims for injuries [17][18][19][20][21][22]. A study involving medical claim data in the U.S. showed that for ages 0-64 years, more severe injuries (versus less severe injuries) and an increasing number of injuries were positively association with ADHD [17].…”

Section: Introductionmentioning

confidence: 99%

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Attention-Deficit Hyperactivity Disorder and Comorbid Mental Health Conditions Associated with Increased Risk of Injury

Merrill

Madsen

2022

Psychiatry Journal

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Background. To describe the influence of attention-deficit hyperactivity disorder (ADHD) and comorbid mental health conditions on the risk of selected injuries. Methods. A retrospective cohort study design was employed using medical claim data from the Deseret Mutual Benefit Administrators (DMBA). Mental health conditions, injury, medication, and demographic data were extracted from claim files for ages 4-64, years 2016-2020. Results. Approximately 51.8% of individuals with ADHD had one or more comorbid mental health conditions (anxiety [37.0%], depression [29.9%], autism spectrum disorder (ASD) [3.6%], bipolar disorder [4.7%], obsessive compulsive disorder (OCD) [2.4%], schizophrenia [0.9%], and manic disorder [0.2%]). The rate of injury was 1.33 (95% CI 1.27–1.39) for ADHD only versus no ADHD and 1.62 (95% CI 1.56–1.68) for ADHD and comorbid mental health conditions versus no ADHD, after adjusting for age, sex, salary, and year. Cases with ADHD but no comorbid mental health conditions versus no ADHD were at increased risk of each of 12 types of injury. The increased risk was noticeably more pronounced for ADHD cases with one or more comorbid mental health conditions versus no ADHD. The greatest increased risk of injury was among ADHD cases with comorbid schizophrenia, followed by bipolar disorder and OCD. Comorbid autism disorder does not increase the risk of injury, but lowers it. Finally, the number of comorbid mental health conditions among ADHD cases was positively associated with increased injury rates (6% for one, 30% for two, 65% for three, and 129% for four). Conclusions. ADHD is positively associated with an increased risk of injury. Comorbid mental health conditions further increase the risk of injury among those with ADHD.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Attention-Deficit Hyperactivity Disorder and Comorbid Mental Health Conditions Associated with Increased Risk of Injury

Merrill

Madsen

2022

Psychiatry Journal

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“…More and more work has shown a link between behavioural disorders (such as ADHD) and learning disabilities as contributing factors to concussion symptom and severity presentation [45][46][47][48]. As an example, participants with ADHD were significantly more disabled after suffering a concussion than were control participants without ADHD, even when controlling for age and sex [49][50][51][52][53].…”

Section: Agementioning

confidence: 99%

Interaction between Age, Sex, and Mental Health Status as Precipitating Factors for Symptom Presentation in Concussed Individuals

Lariviere

Bureau

Marshall³

et al. 2019

Journal of Sports Medicine

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Concussions are among the most common neurological conditions, with emergency departments and sports injury clinics seeing hundreds of patients each year. The consideration of risk factors such as age, sex, and comorbid conditions are very important when looking at individual physiological and psychological outcomes after a concussion. The purpose of this study was to look at four comorbid conditions (depression, anxiety, behavioural disorder, or learning disability) and identify any interactions with age and sex in symptom presentation after suffering a concussion. A total of 4,865 participants from the CCMI (Complete Concussion Management Inc.) dataset were used with 1,577 self-identified with a diagnosis of anxiety, depression, a behavioural disorder, or a learning disability. Fixed-factor analyses of variance were used with age and sex as fixed, grouping factors and symptom total and severity as dependent measures. For the individuals who did not have one of the 4 mental health conditions (3,288 control participants), symptom total and symptom severity increased with age (p<0.05), and females showed more symptoms and a higher symptom severity than males across all ages (p<0.05). A diagnosis of anxiety or depression exacerbated total symptoms and symptom severity from 25–50% above control levels in the 19 and under age groups, while depression or anxiety exacerbated total symptoms and severity by 10–15% in males more than females over 20. A diagnosis of a behavioural disorder or a learning disability exacerbated symptom severity by approximately 50% above control levels in 13–19–year-old females and in males of 30 years and older. This study highlights how the presence of a mental health condition may alter concussion symptom presentation dependent on age and sex. The identification of risk factors and how they may interact can be of great value to health care providers who manage concussion symptoms and recovery.

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“…Moreover, given that parents of ADHD children are themselves at a higher risk of ADHD [ 17 ], the effectiveness of parent training may be compromised [ 18 ]. Furthermore, previous studies found that not only were children with ADHD prone to injuries [ 19 , 20 ], but this risk was also higher in the preschool population [ 19 ]. Indeed, a previous survey also showed that more than 50% of clinicians may recommend medication use for preschool children diagnosed with ADHD due to concerns over the impact of impulsiveness on their physical safety.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and tolerability of psychostimulants for symptoms of attention-deficit hyperactivity disorder in preschool children: A systematic review and meta-analysis

et al. 2023

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Background. There was no previous meta-analysis investigating the efficacy/tolerability of psychostimulants for symptoms of attention-deficit hyperactivity disorder (ADHD) in preschool children. Methods. Databases including PubMed, the Cochrane Library, EMBASE, ScienceDirect, and ClinicalTrials.gov were searched from inception to March 2022 for randomized controlled trials (RCTs) on therapeutic efficacy of psychostimulants against ADHD symptoms in preschool children (age ≤6 years) compared with placebos. Primary outcomes were (a) changes in ADHD symptoms evaluated by validated rating scales from parents'/teacher's observation, or (b) postintervention improvements in neuropsychological performance. Secondary outcomes were risks of adverse events. Results. Meta-analysis of nine eligible trials including 544 preschool children (mean age=4.86 years, female=11.98%, median treatment duration=4.33 weeks) supported the efficacy of psychostimulants against global symptoms from observations of parents (Hedges' g=0.6152, p<0.0001) and teachers (Hedges' g=0.6563, p=0.0039). Efficacy of psychostimulants was also noted against symptoms of inattention and hyperactivity/impulsivity, especially the latter (i.e., main symptoms in preschool children). Moreover, male gender, older age, and longer treatment duration were associated with better efficacy. Regarding adverse events, only the risk of poor appetite was higher in the psychostimulant group (odds ratio [OR]=2.39). However, the qualities of evidence were low to very low, indicating potential discrepancy between the true and estimated effect. Conclusions. Our results showed that psychostimulants might be beneficial for preschool children with ADHD, especially hyperactivity/impulsivity from teachers' observation, with tolerable side effects. Nevertheless, the true magnitude of the effect needs to be confirmed with more research due to low to very low certainty of the evidence.

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Risk of mild head injury in preschool children: relationship to attention deficit hyperactivity disorder symptoms

Cited by 6 publications

References 50 publications

Attention-Deficit Hyperactivity Disorder and Comorbid Mental Health Conditions Associated with Increased Risk of Injury

Attention-Deficit Hyperactivity Disorder and Comorbid Mental Health Conditions Associated with Increased Risk of Injury

Interaction between Age, Sex, and Mental Health Status as Precipitating Factors for Symptom Presentation in Concussed Individuals

Efficacy and tolerability of psychostimulants for symptoms of attention-deficit hyperactivity disorder in preschool children: A systematic review and meta-analysis

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