Attention deficit hyperactivity disorder and increased risk of injury.
OBJECTIVE
This study describes the influence of attention deficit hyperactivity disorder (ADHD) on the incidence rates of selected injuries.


METHODS
A retrospective cohort study design was employed using medical claims data from the Deseret Mutual Benefit Administrators (DMBA), a health insurance company for employees of the Church of Jesus Christ of Latter-day Saints (LDS) and their spouses and dependent children. ADHD diagnosis, injury, medication, and demographic data were extracted from claims files during 1998-2005 for all enrollees aged 0-64 years.


RESULTS
Incidence rates of ADHD were 1.83 (95% CI 1.68-2.00) times greater in males than females and highest in the age group 5-9 years and income group $80,000 or greater. ADHD increased the risk of selected injuries. The most common injuries involved sprains and strains of joints, then open wounds of the head, neck and trunk, and upper/lower limb, and then fractures of the upper/lower limb. Medication did not significantly protect against injury in ADHD patients. The rate of severe injury (i.e., fracture of skull, neck and trunk; intracranial injury excluding those with skull fracture; and injuries to nerves and spinal cord) was 3.07 (95% CI 2.37-3.98) times more common in ADHD enrollees compared with non-ADHD enrollees. Those with 1, 2, 3, or 4 or more injuries were 1.67 (1.50-1.86), 2.11 (1.75-2.56), 2.63 (1.80-3.84), and 2.94 (1.47-5.87) times more likely to have ADHD, respectively.


CONCLUSIONS
ADHD is positively associated with injuries. More severe injuries have a significantly stronger associated with ADHD than less severe injuries.
Merrill
R M
RM
Department of Health Science, College of Health and Human Performance, Brigham Young University, Provo, Utah 84604, USA. Ray_Merrill@byu.edu
Lyon
J L
JL
Baker
R K
RK
Gren
L H
LH
D000293:Adolescent; D000328:Adult; D000375:Aging; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D014947:Wounds and Injuries / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult