The association between traumatic brain injury and ADHD in a Canadian adult sample.
OBJECTIVE
This study describes the association between lifetime traumatic brain injury (TBI) and attention deficit and hyperactivity disorder (ADHD) among Canadian adults.


METHODS
A cross-sectional sample of 3993 Ontario adults aged 18 or older were surveyed by Computer Assisted Telephone Interviewing (CATI) throughout 2011 and 2012 as part of the CAMH Monitor, a rolling survey assessing the health, mental health and substance use of Ontario adults. TBI was defined as trauma to the head that resulted in loss of consciousness for at least five minutes or overnight hospitalization. ADHD was measured by the 6-item ASRS screener for adult ADHD, and self-reported history of diagnosed ADHD.


RESULTS
Among adults with a history of TBI, 6.6% (95% CI: 4.7, 9.4) screened ADHD positive, and 5.9% (95% CI: 3.6, 9.5) reported having been diagnosed with ADHD in their lifetime. Adults with lifetime TBI had significantly greater odds of scoring positive on the ADHD/ASRS screen (OR = 2.49, 95% CI: 1.54, 4.04), and of reporting a history of diagnosed ADHD (OR = 2.64, 95% CI: 1.40, 4.98) than without TBI, when holding values of sex, age, and education constant.


CONCLUSIONS
Significant positive associations between lifetime TBI and both current and past ADHD were observed among adults in this population. More research to understand these associations, and their significance for the etiology and management of TBI and ADHD, is needed.
Division of Neurosurgery, St. Michael Hospital, Toronto, Canada; Department of Psychology, University of Toronto, Toronto, Canada. Electronic address: ilieg@smh.ca.
Gabriela
G
Ilie
Population and Community Health Unit, Department of Family Medicine, University of Western Ontario, London, Canada.
Evelyn R
ER
Vingilis
Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Robert E
RE
Mann
Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Hayley
H
Hamilton
Department of Psychology, York University, LaMarsh Centre for Child and Youth Research, Toronto, Canada.
Maggie
M
Toplak
Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Edward M
EM
Adlaf
Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
Nathan
N
Kolla
Centre for Addiction and Mental Health, Toronto, Canada.
Anca
A
Ialomiteanu
Department of Sociology, University of Toronto, Toronto, Canada.
Mark
M
van der Mass
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada.
Mark
M
Asbridge
Department of Psychology, University of Toronto, Toronto, Canada.
Larissa
L
Vingilis-Jaremko
Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Jürgen
J
Rehm
Division of Neurosurgery, St. Michael Hospital, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Michael D
MD
Cusimano
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000453:epidemiology*; D001930:Brain Injuries / Q000150:complications / Q000453:epidemiology*; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D013689:Telephone; D055815:Young Adult
ADHD; Anxiety; Attention deficit disorders; Ontario adults; Population survey; Traumatic brain injury