title: Factors associated with attention deficit/hyperactivity disorder among US children: results from a national survey.
abstract: BACKGROUND
  The purpose of this study was to investigate the association between Attention Deficit/Hyperactivity Disorder (ADHD) and various factors using a representative sample of US children in a comprehensive manner. This includes variables that have not been previously studied such as watching TV/playing video games, computer usage, family member's smoking, and participation in sports.
  
  
  METHODS
  This was a cross-sectional study of 68,634 children, 5-17 years old, from the National Survey of Children's Health (NSCH, 2007-2008). We performed bivariate and multivariate logistic regression analyses with ADHD classification as the response variable and the following explanatory variables: sex, race, depression, anxiety, body mass index, healthcare coverage, family structure, socio-economic status, family members' smoking status, education, computer usage, watching television (TV)/playing video games, participation in sports, and participation in clubs/organizations.
  
  
  RESULTS
  Approximately 10% of the sample was classified as having ADHD. We found depression, anxiety, healthcare coverage, and male sex of child to have increased odds of being diagnosed with ADHD. One of the salient features of this study was observing a significant association between ADHD and variables such as TV usage, participation in sports, two-parent family structure, and family members' smoking status. Obesity was not found to be significantly associated with ADHD, contrary to some previous studies.
  
  
  CONCLUSIONS
  The current study uncovered several factors associated with ADHD at the national level, including some that have not been studied earlier in such a setting. However, we caution that due to the cross-sectional and observational nature of the data, a cause and effect relationship between ADHD and the associated factors can not be deduced from this study. Future research on ADHD should take into consideration these factors, preferably through a longitudinal study design.
authors.affiliation: Department of Biostatistics, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Ravi K
authors.initials: RK
authors.lastname: Lingineni
authors.forename: Swati
authors.initials: S
authors.lastname: Biswas
authors.forename: Naveed
authors.initials: N
authors.lastname: Ahmad
authors.forename: Bradford E
authors.initials: BE
authors.lastname: Jackson
authors.forename: Sejong
authors.initials: S
authors.lastname: Bae
authors.forename: Karan P
authors.initials: KP
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D014481:United States