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ADHD Diagnoses More Common in Children With Severe Traumatic Brain Injury
Severe traumatic brain injury (TBI) in children is associated with increased risk for attention-deficit/hyperactivity disorder (ADHD), according to meta-analysis findings published in JAMA Pediatrics.
“Of 5920 children with severe TBI, 35.5% (95% CrI, 20.6%-53.2%) had ADHD more than 1 year postinjury,” reported lead author Robert F. Asarnow, PhD, of the University of California, Los Angeles, and coauthors.
The meta-analysis included 24 studies that looked at ADHD diagnoses in children ages 4 through 18 after concussions and mild, moderate, or severe TBI. The studies spanned 12,374 pediatric patients with TBI and 43,491 control subjects.
Related: Mood Disorders Associated With Significant ADHD Risk
Compared with noninjured controls or controls with other injuries, severe TBI was associated with a heightened risk of ADHD. According to the study, odds ratios for ADHD following severe TBI were 4.81 at 1 year and 6.70 after 1 year compared with children with other injuries, and were 2.62 at 1 year and 6.25 afterward compared with noninjured controls.
The meta-analysis found no association between ADHD and concussion, mild TBI, or moderate TBI. Compared with children without injuries, odds ratios for ADHD at 1 year were 0.32 in children with concussion, 0.56 in children with mild TBI, and 1.28 in children with moderate TBI.
The meta-analysis also revealed a rate of pre-TBI ADHD diagnoses (16%) that was significantly greater than the ADHD incidence in the general pediatric population (10.8%).
“The high rate of preinjury ADHD in children with TBI suggests that clinicians should carefully review functioning before a TBI before initiating treatment,” researchers advised.
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