1
|
Israel A, Merzon E, Krone B, Faraone SV, Green I, Golan Cohen A, Vinker S, Cohen S, Ashkenazi S, Magen E, Weizman A, Manor I. The Association Between Repeated Measured Febrile Episodes During Early Childhood and Attention Deficit Hyperactivity Disorder: A Large-Scale Population-Based Study. J Atten Disord 2024; 28:677-685. [PMID: 38281128 DOI: 10.1177/10870547231215289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2024]
Abstract
OBJECTIVE We examined the association between the number, magnitude, and frequency of febrile episodes during the 0 to 4 years of life and subsequent diagnosis of ADHD. METHODS This population-based case-control study in an Israeli HMO, Leumit Health Services (LHS), uses a database for all LHS members aged 5 to 18 years between 1/1/2002 and 1/30/2022. The number and magnitude of measured fever episodes during the 0 to 4 years were recorded in individuals with ADHD (N = 18,558) and individually matched non-ADHD controls in a 1:2 ratio (N = 37,116). RESULTS A significant, independent association was found between the number and magnitude of febrile episodes during the 0 to 4 years and the probability of a later diagnosis of ADHD. Children who never had a measured temperature >37.5°C had a significantly lower rate of ADHD (OR = 0.834, 95% CI [0.802, 0.866], p < .0001). CONCLUSIONS Febrile episodes during 0 to 4 years are associated with a significantly increased rate of a later diagnosis of ADHD in a doseresponse relationship.
Collapse
Affiliation(s)
- Ariel Israel
- Department of Epidemiology and Disease Prevention, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eugene Merzon
- Department of Epidemiology and Disease Prevention, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Beth Krone
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Ilan Green
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Shlomo Vinker
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Shai Ashkenazi
- Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Eli Magen
- Ben-Gurion University of the Negev Marcus Family Campus, Beer-Sheva, Israel
| | | | - Iris Manor
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
2
|
Merzon E, Magen E, Ashkenazi S, Weizman A, Manor I, Krone B, Green I, Golan-Cohen A, Vinker S, Faraone SV, Israel A. The Association between Glucose 6-Phosphate Dehydrogenase Deficiency and Attention Deficit/Hyperactivity Disorder. Nutrients 2023; 15:4948. [PMID: 38068806 PMCID: PMC10708268 DOI: 10.3390/nu15234948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/09/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency, impacting 4.9% of the population and more prevalent in Mediterranean communities, is a common enzymopathy with potential relevance to Attention Deficit/Hyperactivity Disorder (ADHD). This study investigated this association. METHODS The clinical characteristics of 7473 G6PD-deficient patients and 29,892 matched case-controls (selected at a 1:4 ratio) from a cohort of 1,031,354 within the Leumit Health Services database were analyzed using Fisher's exact test for categorical variables and the Mann-Whitney U test for continuous variables. RESULTS In total, 68.7% were male. The mean duration of follow-up was 14.3 ± 6.2 years at a mean age of 29.2 ± 22.3 years. G6PD deficiency was associated with an increased risk of being diagnosed with ADHD (Odds Ratio (OR) = 1.16 [95% CI, 1.08-1.25], p < 0.001), seeking care from adult neurologists (OR = 1.30 [95% CI, 1.22-1.38], p < 0.001), and consulting adult psychiatrists (OR = 1.12 [95% CI, 1.01-1.24], p = 0.048). The use of stimulant medications among G6PD-deficient individuals was 17% higher for the methylphenidate class of drugs (OR = 1.17 [95% CI, 1.08, 1.27], p < 0.001), and there was a 16% elevated risk for amphetamine use (OR = 1.16 [95% CI, 1.03, 1.37], p = 0.047). CONCLUSIONS G6PD deficiency signals an increased risk of ADHD diagnosis, more severe presentations of ADHD and a greater need for psychiatric medications to treat ADHD.
Collapse
Affiliation(s)
- Eugene Merzon
- Adelson School of Medicine, Ariel University, Ariel 40776, Israel;
- Leumit Health Services, Tel Aviv 64738, Israel; (I.G.); (A.G.-C.); (S.V.); (A.I.)
| | - Eli Magen
- Department of Medicine A, Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben Gurion University, Beer Sheba 84990, Israel;
| | - Shai Ashkenazi
- Adelson School of Medicine, Ariel University, Ariel 40776, Israel;
| | - Abraham Weizman
- ADHD Unit, Geha Mental Health Center, Petah Tikva 49100, Israel; (A.W.); (I.M.)
- Department of Psychiatry, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Laboratory of Molecular and Biological Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Iris Manor
- ADHD Unit, Geha Mental Health Center, Petah Tikva 49100, Israel; (A.W.); (I.M.)
- Department of Psychiatry, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Beth Krone
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Ilan Green
- Leumit Health Services, Tel Aviv 64738, Israel; (I.G.); (A.G.-C.); (S.V.); (A.I.)
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Avivit Golan-Cohen
- Leumit Health Services, Tel Aviv 64738, Israel; (I.G.); (A.G.-C.); (S.V.); (A.I.)
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Shlomo Vinker
- Leumit Health Services, Tel Aviv 64738, Israel; (I.G.); (A.G.-C.); (S.V.); (A.I.)
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Stephen V. Faraone
- Department of Psychiatry, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA;
| | - Ariel Israel
- Leumit Health Services, Tel Aviv 64738, Israel; (I.G.); (A.G.-C.); (S.V.); (A.I.)
- Department of Epidemiology and Disease Prevention, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| |
Collapse
|
3
|
Wang J, Li Y, Geng X, Zhang X, Xiao Y, Wang W. Associations of Epstein-Barr Virus Infection with Attention Deficit Hyperactivity Disorder, Learning Disability, and Special Education in US Children. Int J Gen Med 2022; 15:2187-2195. [PMID: 35241933 PMCID: PMC8887610 DOI: 10.2147/ijgm.s355263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
Background Most infections of Epstein-Barr virus (EBV), which is potentially neurotropic, occur in childhood, but little is known about its association with child neurodevelopmental outcomes. Patients and Methods We investigated whether EBV seropositivity was associated with parent-reported attention deficit hyperactivity disorder (ADHD), learning disability, or special education utilization among children, using data from the National Health and Nutrition Examination Survey (NHANES) 2003–2004. Potential confounding factors were adjusted using survey logistic regression models. Results EBV seroprevalence was 69.6% (95% CI, 67.1–72.1%) for US children aged 6–19. The prevalence was 8.86% (95% CI, 7.47–10.47%) for ADHD among 6–19 year olds, 11.70% (95% CI, 9.84–13.87%) for learning disability among 6–15 year olds, and 10.18% (95% CI, 8.58–12.05%) for special education among 6–17 year olds. Children with positive anti-EBV had higher crude prevalence rates of learning disability and special education but not ADHD compared with those with negative anti-EBV. The adjusted odds ratios were 2.76 (95% CI, 1.53–4.96) for learning disability, 3.58 (95% CI, 1.92–6.55) for special education, and 0.77 (95% CI, 0.42–1.38) for ADHD, when comparing children with positive and negative anti-EBV. Conclusion EBV seropositivity was associated with learning disability and special education among US children. Future studies that longitudinally examine the associations are warranted.
Collapse
Affiliation(s)
- Jingjing Wang
- Department of Pediatrics, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Yaping Li
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Xiaozhen Geng
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Xin Zhang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Yanfeng Xiao
- Department of Pediatrics, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Yanfeng Xiao, Department of Pediatrics, Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, Shaanxi, People’s Republic of China, Tel +8602987679273, Email
| | - Wenjun Wang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Correspondence: Wenjun Wang, Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, Shaanxi, People’s Republic of China, Tel +8615091052402, Email
| |
Collapse
|
4
|
Sadaka Y, Freedman J, Ashkenazi S, Vinker S, Golan-Cohen A, Green I, Israel A, Eran A, Merzon E. The Effect of Antibiotic Treatment of Early Childhood Shigellosis on Long-Term Prevalence of Attention Deficit/Hyperactivity Disorder. Children (Basel) 2021; 8:children8100880. [PMID: 34682145 PMCID: PMC8535120 DOI: 10.3390/children8100880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 11/16/2022]
Abstract
It has recently been shown that children with early shigellosis are at increased risk of attention deficit/hyperactivity disorder (ADHD). This study aimed to evaluate the association between antibiotic treatment of shigellosis with long-term ADHD rates. A retrospective cohort study was conducted that included all the Leumit Health Services (LHS) enrollees aged 5-18 years between 2000-2018 with a documented Shigella-positive gastroenteritis before the age of 3 years. Of the 5176 children who were positive for Shigella gastroenteritis before the age of 3 years, 972 (18.8%) were treated with antibiotics early (<5 days), 250 (4.8%) were treated late (≥5 days), and 3954 children (76.4%) were not prescribed antibiotics. Late antibiotic treatment was associated with significantly increased rates of ADHD (adjusted OR = 1.61; 95% CI, 1.1-2.3). Early treatment with antibiotics was not associated with increased ADHD rates (adjusted OR = 1.02; 95% CI, 0.8-1.3). In conclusion, late antibiotic treatment of early childhood shigellosis was associated with increased rates of ADHD.
Collapse
Affiliation(s)
- Yair Sadaka
- The Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8443944, Israel; (Y.S.); (J.F.)
- Neuro-Developmental Research Center, Mental Health Institute, Beer Sheva 8461144, Israel
| | - Judah Freedman
- The Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8443944, Israel; (Y.S.); (J.F.)
- Neuro-Developmental Research Center, Mental Health Institute, Beer Sheva 8461144, Israel
| | - Shai Ashkenazi
- The Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - Shlomo Vinker
- Leumit Health Services, Tel-Aviv 6473817, Israel; (S.V.); (A.G.-C.); (A.I.)
- Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Avivit Golan-Cohen
- Leumit Health Services, Tel-Aviv 6473817, Israel; (S.V.); (A.G.-C.); (A.I.)
- Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Ilan Green
- Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Ariel Israel
- Leumit Health Services, Tel-Aviv 6473817, Israel; (S.V.); (A.G.-C.); (A.I.)
| | - Alal Eran
- Department of Life Sciences, Ben Gurion University, Beer Sheva 8443944, Israel;
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Eugene Merzon
- Leumit Health Services, Tel-Aviv 6473817, Israel; (S.V.); (A.G.-C.); (A.I.)
- Correspondence: ; Tel.: +972-50-7643281
| |
Collapse
|