Association of Allergic Diseases with Attention-Deficit Hyperactivity Disorder and Oppositional Defiant Disorder among Children
Date Issued
2012
Date
2012
Author(s)
Hwang, Yu-Ya
Abstract
Background：
Mental health problems, like Attention-deficit/ hyperactivity disorder (ADHD) and Oppositional defiant disorder (ODD) had increasing prevalence among children, so did the allergic diseases (atopic dermatitis, asthma, and allergic rhinitis).
Recently, there were literatures reporting the association of allergic diseases with ADHD. A cross-sectional study was held here to clarify the association.
Material & Methods:
The Taiwan Children Health Study (TCHS) is an ongoing cohort study. Fourth-grade children were enrolled from 14 diverse Taiwanese communities in 2010. We obtained 2896 subjects data in 2011. The questionnaires included: Swanson, Nolan and Pelham questionnaire (SNAP-IV 26), Center for Epidemiologic Studies Depression Scale (CES-D), Perceived Stress Scale (PSS), and Pittsburgh Sleep Quality Index (PSQI).
Result:
The overall prevalence of ever AD, asthma, and AR were 9.1%, 9.7% and 31.6% respectively. The symptom of AD, asthma, and AR within recent one year was 7.0%, 3.0%, and 19.9%. The prevalence of having symptom of ADHD was 6.1%, while the ADHD subtypes like ADHD-inattention, ADHD-hyperactivity, ADHD-combined were 3.0%, 4.6%, and 2.2% respectively, and the ODD was 2.9%.
Children with AD within recent one year had higher risk to developed symptom of ADHD (OR 1.88, 95%CI 1.15-3.07), ADHD-inattention (OR 2.86, 95%CI 1.56-5.24) and ODD (OR 2.28, 95%CI 1.21-4.31). Children with asthma episode within recent one year had higher risk to developed symptom of ODD (OR 2.69, 95%CI 1 .12-6.44). AR within recent one year had higher risk to developed symptom of ADHD-inattention (OR 1.61, 95%CI 1.00-2.58) and ADHD-combined (OR 2.56, 95%CI 1 .52 to 4.31).
The interaction analysis showed depression interacted with ever asthma toward symptom of ODD significantly (P=0.02). Children with asthma and depressive symptom had higher risk in ODD (OR 8.54, 95%CI 3 .87 to 18.87).
Stress interacted with ever AD significantly toward symptom of ADHD, ADHD-hyperactivity impulsitivity, ADHD-combined and ODD (P=0.03, P=0.02, P=0.05, and P=0.008).
Poor sleep quality interacted with ever asthma toward symptom of ODD significantly (P=0.03). Children with asthma and poor sleep quality had higher risk in ODD (OR 8.24, 95%CI 3 .58 to 18.98).
Conclusion:
Children with allergic disease, like AD, asthma, and allergic rhinitis may have higher risk to develop different subtypes of ADHD or ODD. The strongest association was noted in “AD within one year”.
AD patients interacted with stress to develop symptoms of ADHD and ODD. Stress is an effect modifier between AD and ADHD. However, Asthma patients interacted with depression and poor sleep quality to developed symptoms of ODD. Depression and poor sleep quality are effect modifiers between asthma and ODD.
We concluded that there were different pathways between allergic diseases and ADHD/ODD. A fulfill prevention, education, and treatment program composing by many specialists is the future trend.
Subjects
allergic disease
atopic dermatitis
asthma
allergic rhinitis
attention-deficit hyperactivity disorder
ADHD
oppositional defiant disorder
ODD
depression
stress
sleep quality
SDGs
Type
thesis
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