PURPOSE OF THE STUDY.
To determine if an association exists between atopic dermatitis and attention deficit (hyperactivity) disorder (ADD/ADHD) in children and adults and to describe the factors that contribute to such an association.
This study analyzed pooled data from 19 US population-based surveys that included 354 416 children and adolescents aged 2–17 years.
Cross-sectional data were analyzed from 19 US population-based surveys, each assembled by the National Center for Health Statistics, including the 1997–2013 National Health Interview Survey and the 2003–2004 and 2007–2008 National Survey of Children’s Health. Associations of both atopic dermatitis and ADD/ADHD were examined in children aged 2–17 years, including sex, age, race, household income, highest level of household/parental education, birthplace in the US or elsewhere, and insurance coverage. Bivariate and multivariate logistic regression models were used in statistical analysis.
The pooled prevalence of atopic dermatitis was 10.1%, and the pooled prevalence of ADD/ADHD was 7.3%. Children with atopic dermatitis demonstrated an association with ADD/ADHD (adjusted odds ratio [95% confidence interval], 1.14 [1.03–1.26]). Children with both severe atopic dermatitis and only 0–3 nights of adequate sleep per week had much higher odds of ADD/ADHD (16.83 [7.02–40.33]) than those with 0–3 nights of adequate sleep per week (1.83 [1.47–2.26]) or mild to moderate atopic dermatitis alone (1.56 [1.22–1.99]). Atopic dermatitis in the absence of other allergic diseases was also associated with increased risk of ADD/ADHD in children. For children with atopic dermatitis, a history of anemia, headaches, and obesity were associated with higher odds of ADD/ADHD.
Atopic dermatitis in children is associated with increased odds of ADD/ADHD. Headaches, obesity, and anemia occurring in children with atopic dermatitis further increase the risk of ADD/ADHD.
This study demonstrates that atopic dermatitis in the absence of other allergic diseases in children is associated with increased risk of ADD/ADHD. Furthermore, severe atopic dermatitis and sleep disturbance may act both independently and synergistically to increase the risk of ADD/ADHD. Improved understanding of these risk associations between atopic dermatitis and ADD/ADHD will assist in the clinical care of these children.
- Copyright © 2017 by the American Academy of Pediatrics