PURPOSE OF THE STUDY.
To determine if children with attention-deficit/hyperactivity disorder (ADHD) were more likely than matched controls to have been previously managed for atopic diseases. Furthermore, the authors sought to study the effect on children’s ADHD medication use when parents were in treatment for ADHD and atopic diseases.
Children 6 to 12 years of age and their parents from a northern region of the Netherlands were included.
This was a retrospective case-control study of children identified via regional pharmacy dispensing data from 1994 and 2013. The cases of the children reviewed had at least 2 prescriptions of methylphenidate within a 1-year period. Each child with ADHD was matched to 4 controls on the basis of sex, date of birth, and location. Parental prescription data for ADHD and atopic diseases were linked to the children with ADHD and controls. Data were analyzed by using conditional logistic regression and multivariable conditional logistic regression models.
A total of 4257 cases of children treated for ADHD and 17 028 corresponding controls were found. The mean age of the children on ADHD medication was 8.3 years, and the group was predominantly made up of boys (76.7%); similar findings were seen in the matched control group. Children on ADHD medications were more likely than controls to have received medications for asthma (odds ratio [OR]: 1.4; 95% confidence interval [CI]: 1.3–1.6), allergic rhinitis (OR: 1.4; 95% CI: 1.1–1.8), and eczema (OR: 1.3; 95% CI: 1.1–1.5). The children with ADHD were more likely to have a parent on ADHD medication when compared with the control group (OR: 3.8; 95% CI: 3.3–4.3). Parental use of medications for allergic rhinitis (OR: 1.3; 95% CI: 1.1–1.5) and asthma (OR: 1.2; 95% CI: 1.1–1.3), but not eczema (OR: 1.1; 95% CI: 1.0–1.2), was associated with their child receiving ADHD medication.
Children with a history of medically treated atopic disease are at an increased risk of receiving ADHD drug treatment. Additionally, if the parent of the child had taken medication for asthma or allergic rhinitis, the child was also at an increased risk of using ADHD medication. These findings imply a link between atopic disease and ADHD that may be based on inherited and/or environmental factors.
As ADHD and atopic disease have almost synchronously increased in prevalence, questions into possible etiologies and/or links have been raised. Whether atopic disease is implicated as a causative factor in the etiology of ADHD or may be considered a strong risk factor in its development is not clear and requires further investigation. This study aids in increasing provider awareness that atopic disease may be linked to ADHD. Also, the importance of a thorough family history as means to providing proper anticipatory guidance to patients and families is stressed in this study.
- Copyright © 2017 by the American Academy of Pediatrics