Health-related impairments in young children with ADHD: a community-based study.
We aimed to examine health-related impairments in young children with attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls and explore differences in children with ADHD by gender, ADHD subtype and mental health co-morbidity status.



Children with ADHD (n = 177) and controls (n = 212) aged 6-8 years were recruited across 43 schools in Melbourne, Australia following a screening (Conners 3 ADHD Index) and case confirmation procedure (Diagnostic Interview Schedule for Children IV). Direct and blinded assessments of height and weight were used to calculate body mass index z-score and to identify overweight/obesity. Parents reported on child global health, sleep problems and physical injuries. Unadjusted and adjusted (socio-demographic factors and co-morbidities) logistic and linear regression were conducted to compare health-related impairments between (1) children with and without ADHD; (2) boys and girls with ADHD; (3) children with ADHD-inattentive and ADHD-combined types; and (4) children with ADHD by internalizing and externalizing disorder status.



Children with ADHD had poorer global health than controls when adjusted for socio-demographic characteristics (OR: 2.0; 95% CI 1.1, 3.9); however, this attenuated after adjusting for co-morbidities. In adjusted analyses, children with ADHD had increased odds of moderate/large sleep problems (OR: 3.1; 95% CI 1.4, 6.8), compared with controls. There were no differences between children with and without ADHD in terms of physical injuries or overweight/obesity. Findings were similar when excluding children taking ADHD medication, and health-related impairments did not differ between boys and girls with ADHD. Children with ADHD-combined type had higher BMI z-scores than controls in adjusted analyses (P = 0.04). Children with ADHD and co-occurring internalizing and externalizing co-morbidities were particularly vulnerable to health-related impairments.



Young children with ADHD experience a number of health-related impairments, which are exacerbated by the presence of internalizing and externalizing co-morbidities. Clinicians should consider the broader health of children with ADHD in clinical consultations.
Deakin University, School of Psychology, Geelong, Vic., Australia.|Murdoch Childrens Research Institute, Melbourne, Vic., Australia.|The Royal Children's Hospital, Melbourne, Vic., Australia.|The University of Melbourne, Melbourne, Vic., Australia.
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E
Sciberras
Deakin University, School of Psychology, Geelong, Vic., Australia.|Murdoch Childrens Research Institute, Melbourne, Vic., Australia.
M
M
Bisset
Discipline of Psychiatry, Sydney Medical School, Sydney, NSW, Australia.
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P
Hazell
Murdoch Childrens Research Institute, Melbourne, Vic., Australia.|La Trobe University, Melbourne, Vic., Australia.
J M
JM
Nicholson
Murdoch Childrens Research Institute, Melbourne, Vic., Australia.|The Royal Children's Hospital, Melbourne, Vic., Australia.|The University of Melbourne, Melbourne, Vic., Australia.
V
V
Anderson
Murdoch Childrens Research Institute, Melbourne, Vic., Australia.
K
K
Lycett
Child Development Service, Joondalup, WA, Australia.|The University of Western Australia, Perth, WA, Australia.
B
B
Jongeling
Murdoch Childrens Research Institute, Melbourne, Vic., Australia.|The Royal Children's Hospital, Melbourne, Vic., Australia.|The University of Melbourne, Melbourne, Vic., Australia.
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D
Efron
D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D015992:Body Mass Index; D017028:Caregivers; D016022:Case-Control Studies; D002648:Child; D000067576:Child Health / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology; D050177:Overweight / Q000453:epidemiology / Q000209:etiology; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology; D014739:Victoria / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology
BMI; accidental injury; attention-deficit disorder with hyperactivity; child; obesity; sleep problems