Association Between Atopic Dermatitis and Attention Deficit Hyperactivity Disorder in U.S. Children and Adults

Overview

Journal Br J Dermatol

Publisher Oxford University Press

Specialty Dermatology

Date 2016 Apr 24

PMID 27105659

Citations 55

Authors

M A Strom

A B Fishbein

A S Paller

J I Silverberg

Affiliations

Soon will be listed here.

Abstract

Background: Atopic dermatitis (AD) is associated with chronic itch, allergic disease and sleep disturbance, all of which might increase the risk of attention deficit (hyperactivity) disorder (ADD/ADHD). Previous analyses have found a consistent association between AD and ADD/ADHD, although the underlying factors contributing to such an association remain underexplored. Additionally, the relationship has been underexplored in adults.

Objectives: To determine if childhood and adult AD and AD severity are associated with ADD/ADHD and to delineate the factors contributing to such an association.

Methods: We analysed data on 354 416 children aged 2-17 years and 34 613 adults age 18+ years from 19 U.S. population-based surveys, including the National Health Interview Survey 1997-2013 and the National Survey of Children's Health 2003/4 and 2007/8.

Results: In multivariate models adjusting for age, sex, sociodemographics, allergic disease and healthcare utilization, AD was associated with ADD/ADHD in both children [adjusted odds ratio (95% confidence interval), 1·14 (1·03-1·26)] and adults [1·61 (1·25-2·06)]. Children with both severe AD 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-moderate AD alone [1·56 (1·22-1·99)]. AD was most strongly associated with severe ADHD. AD unaccompanied by other allergic disease was also associated with increased risk of ADD/ADHD in children. Among children with AD, history of anaemia, headaches and obesity were associated with even higher odds of ADD/ADHD. Asthma, insomnia and headaches increased the odds of ADHD in adults with AD, although underweight body mass index was protective.

Conclusions: Atopic dermatitis is associated with increased odds of ADD/ADHD in adults and children. Several factors increase the risk of ADHD in adults and children with AD.

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Clinical Presentation of Atopic Dermatitis.

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References

Silverberg J . Health Care Utilization, Patient Costs, and Access to Care in US Adults With Eczema: A Population-Based Study. JAMA Dermatol. 2015; 151(7):743-52. DOI: 10.1001/jamadermatol.2014.5432. View

Dahl R, Sampson H, Lupo M . Sleep disturbances in children with atopic dermatitis. Arch Pediatr Adolesc Med. 1995; 149(8):856-60. DOI: 10.1001/archpedi.1995.02170210030005. View

Silverberg J . Association between childhood eczema and headaches: An analysis of 19 US population-based studies. J Allergy Clin Immunol. 2015; 137(2):492-499.e5. PMC: 5216169. DOI: 10.1016/j.jaci.2015.07.020. View

Giacobini M, Medin E, Ahnemark E, Russo L, Carlqvist P . Prevalence, Patient Characteristics, and Pharmacological Treatment of Children, Adolescents, and Adults Diagnosed With ADHD in Sweden. J Atten Disord. 2014; 22(1):3-13. DOI: 10.1177/1087054714554617. View

Silverberg J, Simpson E . Association between severe eczema in children and multiple comorbid conditions and increased healthcare utilization. Pediatr Allergy Immunol. 2013; 24(5):476-86. PMC: 4397968. DOI: 10.1111/pai.12095. View

Engel-Yeger B, Mimouni D, Rozenman D, Shani-Adir A . Sensory processing patterns of adults with atopic dermatitis. J Eur Acad Dermatol Venereol. 2010; 25(2):152-6. DOI: 10.1111/j.1468-3083.2010.03729.x. View

Schmitt J, Romanos M, Schmitt N, Meurer M, Kirch W . Atopic eczema and attention-deficit/hyperactivity disorder in a population-based sample of children and adolescents. JAMA. 2009; 301(7):724-6. DOI: 10.1001/jama.2009.136. View

Arruda M, Guidetti V, Galli F, Albuquerque R, Bigal M . Migraine, tension-type headache, and attention-deficit/hyperactivity disorder in childhood: a population-based study. Postgrad Med. 2010; 122(5):18-26. DOI: 10.3810/pgm.2010.09.2197. View

Schmitt J, Apfelbacher C, Chen C, Romanos M, Sausenthaler S, Koletzko S . Infant-onset eczema in relation to mental health problems at age 10 years: results from a prospective birth cohort study (German Infant Nutrition Intervention plus). J Allergy Clin Immunol. 2010; 125(2):404-10. DOI: 10.1016/j.jaci.2009.10.055. View

10.

Konofal E, Lecendreux M, Arnulf I, Mouren M . Iron deficiency in children with attention-deficit/hyperactivity disorder. Arch Pediatr Adolesc Med. 2004; 158(12):1113-5. DOI: 10.1001/archpedi.158.12.1113. View

11.

Bender B, Ballard R, Canono B, Murphy J, Leung D . Disease severity, scratching, and sleep quality in patients with atopic dermatitis. J Am Acad Dermatol. 2008; 58(3):415-20. DOI: 10.1016/j.jaad.2007.10.010. View

12.

Flohr C, Weinmayr G, Weiland S, Addo-Yobo E, Annesi-Maesano I, Bjorksten B . How well do questionnaires perform compared with physical examination in detecting flexural eczema? Findings from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two. Br J Dermatol. 2009; 161(4):846-53. DOI: 10.1111/j.1365-2133.2009.09261.x. View

13.

Silverberg J, Kleiman E, Lev-Tov H, Silverberg N, Durkin H, Joks R . Association between obesity and atopic dermatitis in childhood: a case-control study. J Allergy Clin Immunol. 2011; 127(5):1180-6.e1. DOI: 10.1016/j.jaci.2011.01.063. View

14.

Schmitt J, Buske-Kirschbaum A, Roessner V . Is atopic disease a risk factor for attention-deficit/hyperactivity disorder? A systematic review. Allergy. 2010; 65(12):1506-24. DOI: 10.1111/j.1398-9995.2010.02449.x. View

15.

Shani-Adir A, Rozenman D, Kessel A, Engel-Yeger B . The relationship between sensory hypersensitivity and sleep quality of children with atopic dermatitis. Pediatr Dermatol. 2009; 26(2):143-9. DOI: 10.1111/j.1525-1470.2009.00904.x. View

16.

Schmitt J, Chen C, Apfelbacher C, Romanos M, Lehmann I, Herbarth O . Infant eczema, infant sleeping problems, and mental health at 10 years of age: the prospective birth cohort study LISAplus. Allergy. 2010; 66(3):404-11. DOI: 10.1111/j.1398-9995.2010.02487.x. View

17.

Cortese S, Moreira-Maia C, St Fleur D, Morcillo-Penalver C, Rohde L, Faraone S . Association Between ADHD and Obesity: A Systematic Review and Meta-Analysis. Am J Psychiatry. 2015; 173(1):34-43. DOI: 10.1176/appi.ajp.2015.15020266. View

18.

Susitaival P, Husman L, Hollmen A, Horsmanheimo M . Dermatoses determined in a population of farmers in a questionnaire-based clinical study including methodology validation. Scand J Work Environ Health. 1995; 21(1):30-5. DOI: 10.5271/sjweh.5. View

19.

Silverberg J, Paller A . Association between eczema and stature in 9 US population-based studies. JAMA Dermatol. 2014; 151(4):401-9. DOI: 10.1001/jamadermatol.2014.3432. View

20.

Romanos M, Gerlach M, Warnke A, Schmitt J . Association of attention-deficit/hyperactivity disorder and atopic eczema modified by sleep disturbance in a large population-based sample. J Epidemiol Community Health. 2009; 64(3):269-73. DOI: 10.1136/jech.2009.093534. View