title: Comorbidity of Atopic Disorders with Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder.
abstract: OBJECTIVE
  To assess the relationship between allergic manifestations in early life and the occurrence of newly diagnosed autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) throughout childhood.
  
  
  METHODS
  We collected a population-based longitudinal cohort comprising children enrolled in Taiwan's National Health Insurance Program during 2000-2010. We first identified 387,262 children who had a diagnosis of atopic dermatitis (AD) before age 2 years, with 1:1 individualized matching to children without AD. Cox regression analyses were performed to estimate the early-onset and cumulative effects of allergic manifestations on ASD and ADHD.
  
  
  RESULTS
  An estimated 0.5% of AD-exposed children received a diagnosis of ASD, and 3.7% were diagnosed with ADHD, significantly higher than the respective rates of 0.4% and 2.9% found in their nonexposed peers. Having AD before age 2 years was associated with an increased hazard ratio (HR) for ASD by 10% and that for ADHD by 16%; such increases were particularly prominent among those with earlier-onset or more severe AD. HRs were especially higher for children with persistent AD and emerging atopic respiratory diseases in childhood (eg, for ASD, adjusted HR, 1.75 and 2.13, respectively; P < .001).
  
  
  CONCLUSIONS
  The observed increased risks of ASD and ADHD associated with AD in infancy suggest that a disordered immunologic response may exert effects on neurodevelopment and have implications for research into etiology and treatment strategies.
authors: Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors: Tzu-Chu
authors: TC
authors: Liao
authors: Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Center of Neuropsychiatric Research, National Health Research Institutes, Zhunan, Taiwan.
authors: Yi-Ting
authors: YT
authors: Lien
authors: Institute of Anatomy and Cell Biology, National Yang-Ming University, Taipei, Taiwan.
authors: Sabrina
authors: S
authors: Wang
authors: Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors: Song-Lih
authors: SL
authors: Huang
authors: Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Center of Neuropsychiatric Research, National Health Research Institutes, Zhunan, Taiwan. Electronic address: chuanychen@ym.edu.tw.
authors: Chuan-Yu
authors: CY
authors: Chen
mesh_terms: D001249:Asthma / Q000150:complications / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000453:epidemiology; D000067877:Autism Spectrum Disorder / Q000150:complications* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D016208:Databases, Factual; D003876:Dermatitis, Atopic / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000453:epidemiology; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D065886:Neurodevelopmental Disorders / Q000150:complications; D016016:Proportional Hazards Models; D012220:Rhinitis / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D013624:Taiwan