title: Family-environmental factors associated with attention deficit hyperactivity disorder in Chinese children: a case-control study.
abstract: BACKGROUND
  Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders, affecting an estimated 5 to 12% of school-aged children worldwide. From 15 to 19 million Chinese children suffer from ADHD. The aim of this study was to investigate the association between family-environmental factors and ADHD in a sample of Chinese children.
  
  
  METHODS
  A pair-matched, case-control study was conducted with 161 ADHD children and 161 non-ADHD children of matching age and sex, all from 5-18 years of age. The ADHD subjects and the normal controls were all evaluated via structured diagnostic interviews. We examined the association between family-environmental factors and ADHD using the conditional multiple logistic regression with backward stepwise selection to predict the associated factors of ADHD.
  
  
  RESULTS
  Having experienced emotional abuse and being a single child were both significant factors associated with children diagnosed with ADHD. ADHD subjects were more likely to have suffered from emotional abuse (OR = 11.09, 95% CI = 2.15-57.29, P = 0.004) and have been a single child in the family (OR = 6.32, 95% CI = 2.09-19.14, P = 0.001) when compared to normal controls. The results were not modified by other confounding factors.
  
  
  CONCLUSIONS
  Our findings provide evidence that family-environmental factors are associated with ADHD among children in China. These findings, if confirmed by future research, may help to decrease ADHD by increasing the awareness of the effects of childhood emotional abuse.
authors.affiliation: Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Xianming
authors.initials: X
authors.lastname: du Prel Carroll
authors.forename: Honggang
authors.initials: H
authors.lastname: Yi
authors.forename: Yuezhu
authors.initials: Y
authors.lastname: Liang
authors.forename: Ke
authors.initials: K
authors.lastname: Pang
authors.forename: Sandra
authors.initials: S
authors.lastname: Leeper-Woodford
authors.forename: Patrizia
authors.initials: P
authors.lastname: Riccardi
authors.forename: Xianhong
authors.initials: X
authors.lastname: Liang
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000523:psychology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male