The association of bullying and health complaints in children with attention-deficit/hyperactivity disorder.
BACKGROUND
Attention-deficit/hyperactivity disorder (ADHD) in schoolchildren is often associated with troublesome relationships with family members and peers as well as difficulties in the classroom. The aims of this study were to assess the associations between attention-deficit/hyperactivity disorder (ADHD), recurrent subjective health complaints, and bullying in the peer group in schoolchildren.


METHODS
Cohort study of 577 fourth graders (10-year-olds) in 1 municipality in Stockholm County, Sweden. All children were screened for attention and behavior problems through interviews with their parents and teachers. Children with high scores underwent further clinical and cognitive assessments. Information about health complaints and bullying was collected from the children themselves in a classroom questionnaire. The 516 children for whom there was information from all 3 data sources were included in the final study population.


RESULTS
Attention-deficit/hyperactivity disorder was associated with a 2-fold increased risk for recurrent abdominal pain (RAP), sleeping problems, and tiredness, while there was no association with headache. Bullying other students as well as being bullied were strongly associated with ADHD. There was a 2-fold increased risk for all kinds of health complaints among children being bullied, while bullies were more likely to report tiredness than other children.


CONCLUSIONS
Evaluation and treatment strategies for ADHD need to include an effective evaluation and treatment of RAP, tiredness, and sleeping disturbances as well as assessment and effective interventions for bullying. Evaluation of ADHD should be considered in children with recurrent health complaints and in children involved in bullying. Antibullying interventions are important to prevent health problems in all children.
Holmberg
Kirsten
K
Department of Women's and Children's Health, Section for Paediatrics, Central Unit of Child Healthcare, Uppsala University Children's Hospital, SE-751 85, Uppsala, Sweden. kirsten.holmberg@kbh.uu.se
D015746:Abdominal Pain / Q000453:epidemiology / Q000523:psychology; D000374:Aggression / Q000523:psychology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D015331:Cohort Studies; D004291:Dominance-Subordination; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010379:Peer Group; D012008:Recurrence; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000523:psychology; D013548:Sweden / Q000453:epidemiology