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J Epidemiol Community Health. 2010 Mar;64(3):269-73. doi: 10.1136/jech.2009.093534. Epub 2009 Aug 19.

Association of attention-deficit/hyperactivity disorder and atopic eczema modified by sleep disturbance in a large population-based sample.

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  • 1Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinic of Wuerzburg, Fuechsleinstr 15, 97080 Wuerzburg, Germany. romanos@kjp.uni-wuerzburg.de

Abstract

BACKGROUND:

A cross-sectional study was performed in a population-based German sample (n=13 318 children and adolescents aged 3-17) to replicate the recently reported independent association of atopic eczema (AE) and attention-deficit/hyperactivity disorder (ADHD) and to further investigate the role of environmental and behavioural factors.

METHODS:

The odds ratio (OR) was calculated with allergic comorbidity and various environmental factors considered as confounders and sleeping problems hypothesised to act as a potential effect modifier.

RESULTS:

The lifetime prevalence of AE and ADHD was 14.7% (male 14.4%; female 14.9%) and 4.9% (male 7.8%; female 2.0%), respectively. There was an association between ADHD and AE (OR 1.54; 95% CI 1.24 to 1.93; p<0.001), which was independent of sociodemographic factors, parental smoking, breastfeeding, number of siblings, perinatal health problems, and atopic comorbidity. Further analyses of a subgroup of 6484 children age 3-11 confirmed the hypothesis that the association between AE and ADHD was modified by sleeping problems (interaction effect AE*sleep problems OR 2.02 95% CI 1.03 to 3.97; p=0.04). There was a strong association between AE and ADHD in children with SP (OR 2.67 95% CI 1.51 to 4.71; p=0.001; n=1112), but not in children without SP (OR 1.24 95% CI 0.83 to 1.84; p=0.30; n=5796).

CONCLUSIONS:

ADHD and AE appear to be strongly and independently associated in children with sleeping problems, but not in children without sleeping problems. A substantial part of diagnoses met for ADHD might be engendered by the presence of AE and concomitant sleeping problems.

PMID:
19692717
[PubMed - indexed for MEDLINE]
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