title: Allergic diseases in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis.
abstract: Reports of frequent manifestation of allergic diseases in children with attention deficit hyperactivity disorder (ADHD) have been the subject of mounting clinical interest. However, evidence supporting the association between ADHD and allergies is inconsistent and has yet to be systematically reviewed. The objective of this study was to compile and assess available studies on the association between ADHD and allergic diseases in children.
  
  
  
  A comprehensive search using MEDLINE, EMBASE, the Cochrane library, and CINAHL databases was completed in 23 November 2015. The inclusion criteria for studies were that the research assessed allergic diseases in children, 18 years of age and younger, with a diagnosis of ADHD and that a distinct comparison group was incorporated. Any comparative studies, encompassing both randomized controlled trials and observational studies, were considered for inclusion. Two review authors independently assessed the quality of the selected studies by the use of validated assessment tools, performed data extraction and conducted meta-analysis according to Cochrane Collaboration guidelines.
  
  
  
  Five eligible studies were included in this systematic review. Of these studies, three were case-control and two were cross sectional studies. A majority of information from the five studies was classified as having low or unclear risk of bias. The meta-analysis showed an association between children with ADHD and asthma compared with the control groups (OR: 1.80, 95% CI: 1.57 - 2.07; five studies, low quality of evidence), but did not indicate an association between food allergy and ADHD (OR: 1.13, 95% CI: 0.88 - 1.47; three studies very low quality of evidence). The odds of experiencing allergic rhinitis, atopic dermatitis, and allergic conjunctivitis were slightly higher in children with ADHD compared with control groups, though a substantial statistical heterogeneity was notable in the overall effect estimates.
  
  
  
  The findings from this review and meta-analysis show that children with ADHD are more likely to have asthma, allergic rhinitis, atopic dermatitis, and allergic conjunctivitis than their counterparts. Interventions including strategies for managing allergies in children with ADHD would be beneficial.
authors.affiliation: Department of Health Policy, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
authors.forename: Celine
authors.initials: C
authors.lastname: Miyazaki
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8654, Japan.
authors.forename: Momoko
authors.initials: M
authors.lastname: Koyama
authors.affiliation: Department of Health Policy, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535, Japan. ota@slcn.ac.jp.|Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashicho, Chuo-ku, Tokyo, 104-0044, Japan. ota@slcn.ac.jp.
authors.forename: Erika
authors.initials: E
authors.lastname: Ota
authors.affiliation: Department of Health Policy, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.|Graduate School of Human Sciences, Osaka University, 1-1 Yamadaoka Suita, Osaka Prefecture, 565-0871, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Swa
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8654, Japan.
authors.forename: Linda B
authors.initials: LB
authors.lastname: Mlunde
authors.affiliation: Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8654, Japan.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Amiya
authors.affiliation: Department of Psychosocial Medicine, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Tachibana
authors.affiliation: Department of Medical Specialties, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
authors.forename: Kiwako
authors.initials: K
authors.lastname: Yamamoto-Hanada
authors.affiliation: Department of Health Policy, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
authors.forename: Rintaro
authors.initials: R
authors.lastname: Mori
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000453:epidemiology*; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D065631:Rhinitis, Allergic / Q000175:diagnosis / Q000453:epidemiology*
keywords: Allergic conjunctivitis, Allergic disease, Allergic rhinitis, Asthma, Atopic dermatitis, Attention deficit hyper disorder, Coexisting condition, Food allergy, Meta-analysis