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Xie L, Gelfand A, Mathew MS, Atem FD, Delclos GL, Messiah SE. Association of corticosteroid use and attention deficit/hyperactivity disorder in asthmatic children varies by age. J Asthma 2023; 60:698-707. [PMID: 35696551 DOI: 10.1080/02770903.2022.2089995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We aim to examine the impact of corticosteroids use on ADHD among children with asthma by administration routes. METHODS A population-based, cross-sectional analysis included pediatric patients ages 5-20 years old from the 2016 and 2019 Kids Inpatient Database (unweighted N = 111,702). ICD-10-CM codes were used to identify corticosteroids use, asthma, and ADHD cases. Survey logistic regression models with purposeful variable selection algorithms were built to examine the association between corticosteroids use, and ADHD by asthma severity and age. An inverse probability weighting (IPW) approach was used to help further control residual confounding. RESULTS Among children aged 5-11 years old, the odds of ADHD were significantly higher in children with moderate to severe asthma who used inhaled corticosteroids than nonusers (moderate asthma: adjusted odds ratios [aOR] 1.46, 95% confidence interval [CI] 1.14-2.44; severe asthma: aOR 1.61, 95% CI 1.18-2.21). Although oral corticosteroid use was not independently associated with ADHD in young children, combined use of inhaled and oral corticosteroid had almost 5 times higher odds of use among ADHD in children with severe asthma vs. nonusers (aOR 4.85, 95% CI 2.07 - 11.35). No associations were found between any corticosteroid use and ADHD among asthmatic children aged 12-20 years. CONCLUSIONS In this retrospective analysis, we found inhaled corticosteroids were positively associated with ADHD in younger children with moderate to severe asthma, but not in older children.
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Affiliation(s)
- Luyu Xie
- School of Public Health, University of Texas Health Science Center, Dallas Campus, Dallas, TX, USA
- Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, TX, USA
| | - Andrew Gelfand
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - M Sunil Mathew
- School of Public Health, University of Texas Health Science Center, Dallas Campus, Dallas, TX, USA
- Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, TX, USA
| | - Folefac D Atem
- School of Public Health, University of Texas Health Science Center, Dallas Campus, Dallas, TX, USA
- Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, TX, USA
| | - George L Delclos
- School of Public Health, University of Texas Health Science Center, Houston Campus, Houston, TX, USA
| | - Sarah E Messiah
- School of Public Health, University of Texas Health Science Center, Dallas Campus, Dallas, TX, USA
- Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, TX, USA
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Behmanesh F, Moharreri F, Soltanifar A, Hamzeh M, Heidari E. Evaluation of anxiety and depression in mothers of children with asthma. Electron Physician 2017; 9:6058-6062. [PMID: 29560160 PMCID: PMC5843434 DOI: 10.19082/6058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 08/04/2017] [Indexed: 11/29/2022] Open
Abstract
Background Asthma is the most common chronic disease in childhood. Parents have an important role in managing asthma in children. Studies have shown a higher degree of depression and anxiety and lower family performance in mothers of asthmatic children in comparison with the control group. Objective The aim of this study was to evaluate the parenting styles and also depression, anxiety and stress parameters in mothers of children with asthma. Methods This case-control study was performed on 45 mothers of 3 to 15 years old asthmatic children in the allergy clinic of Mashhad University of Medical Sciences, Mashhad, Iran, during the years of 2014 to 2016. The control group was 45 mothers of non-asthmatic children who were matched for the age of their children with the case group in the same population. The parenting styles, as well as depression and anxiety of mothers were evaluated using parenting scales, and the depression-anxiety-stress scales (DASS). The mothers were also asked to fill a strengths and difficulties questionnaire (SDQ) for their children. Furthermore, parenting styles in the case group were compared to mothers of children without asthma as the control group. The data were then analyzed by SPSS 11.5, using Chi-square, ANOVA, and independent-samples t-test. Results The results of this study showed that 21 mothers (74.6%) were normal, but 12 mothers (26.7%) had a mild −, 9 (20%) a moderate - and 3 (6.7%) a severe degree of abnormality according to DASS. Independent-samples t-test showed a significant difference between the case and control groups regarding depression in mothers and laxness (p<0.001), over reactivity (p<0.013) and verbosity (p<0.031) in children with asthma. Conclusion The results of this study demonstrated that anxiety and depression are partially frequent in mothers of children with asthma, and parenting styles are less affective in these families.
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Affiliation(s)
- Fatemeh Behmanesh
- MD., Associate Professor, Allergy Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Moharreri
- Associate Professor, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Soltanifar
- Associate Professor, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Elahe Heidari
- MD., Assistant Professor, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Kwon HJ, Lee MY, Ha M, Yoo SJ, Paik KC, Lim JH, Sakong J, Lee CG, Kang DM, Hong SJ, Cho HI, Lim MH. The associations between ADHD and asthma in Korean children. BMC Psychiatry 2014; 14:70. [PMID: 24606878 PMCID: PMC3975298 DOI: 10.1186/1471-244x-14-70] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 03/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the associations between attention deficit hyperactivity disorder (ADHD), the most common neuropsychiatric disorder in school children, and childhood allergic disease by evaluating their respective prevalence. METHODS Subjects were comprised of first and second grade students in twenty two elementary schools in a city in the Republic of Korea. The mode of measurement for ADHD was based on DSM-IV from clinical interviews conducted by child psychiatrists. Along with the diagnostic interviews, we also used the epidemiological questionnaires, Computerized Attention Deficit-Hyperactivity Disorder Diagnostic System, the abbreviated Conner's Parent Rating Scale (CPRS), and DuPaul's ADHD Rating Scales. Allergic conditions, such as asthma, have been separately evaluated based on the questionnaire items whose validity and reliability were proved by the International Study of Asthma and Allergies in Children (ISAAC). All questionnaires were completed by the subjects' parents. RESULTS The lifetime prevalence rate of asthma in ADHD patients was 36.6%, compared to a prevalence of 24.3% in control subjects. The lifetime prevalence rate of allergic rhinitis in ADHD patients was 59.0%, compared to a prevalence of 47.0% in control subjects. Statistically significant difference has been found between the two groups. In the logistic regression model of the ADHD and the control group, the relative risk of asthma was 1.60 times higher (confidence interval 1.301-1.964), the relative risk of allergic rhinitis was 1.38 times higher (confidence interval 1.124-1.681), which showed statistical significance. CONCLUSIONS The findings of this study suggest significant association between ADHD and childhood asthma and allergic rhinitis. Therefore, appropriate evaluation and treatment are needed for asthmatic children with attention-deficit symptoms, or allergic rhinitis with ADHD. Besides, further research is needed to determine the etiological approach towards ADHD, asthma, and allergic rhinitis.
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Affiliation(s)
- Ho Jang Kwon
- Environmental Health Center, Dankook University Hospital, Cheonan, Korea
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Korea
| | - Mi Young Lee
- Department of Preventive Medicine, College of Medicine, Keimyung University, Daegu, Korea
| | - Mina Ha
- Environmental Health Center, Dankook University Hospital, Cheonan, Korea
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Korea
| | - Seung Jin Yoo
- Environmental Health Center, Dankook University Hospital, Cheonan, Korea
| | - Ki Chung Paik
- Environmental Health Center, Dankook University Hospital, Cheonan, Korea
- Department of Psychology and Psychiatry, College of Medicine, Dankook University, 359 Manghyang Rho, Cheonan 300-714, South Korea
| | - Jong-Han Lim
- Department of Preventive Medicine, College of Medicine, Inha University, Incheon, Korea
| | - June Sakong
- Department of Preventive Medicine, College of Medicine, Yeongnam University, Daegu, Korea
| | - Chul-Gab Lee
- Department of Preventive Medicine, College of Medicine, Chosun University, Kwangju, Korea
| | - Dong-Muk Kang
- Department of Preventive Medicine, College of Medicine, Pusan University, Pusan, Korea
| | - Soo Jong Hong
- Department of Pediatrics, College of Medicine, Ulsan University, Ulsan, Korea
| | - Hwan Il Cho
- Environmental Health Center, Dankook University Hospital, Cheonan, Korea
- Department of Psychology and Psychiatry, College of Medicine, Dankook University, 359 Manghyang Rho, Cheonan 300-714, South Korea
| | - Myung Ho Lim
- Environmental Health Center, Dankook University Hospital, Cheonan, Korea
- Department of Psychology and Psychiatry, College of Medicine, Dankook University, 359 Manghyang Rho, Cheonan 300-714, South Korea
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Daniali S, Madjd Z, Shahbazi A, Niknazar S, Shahbazzadeh D. Chronic Ritalin administration during adulthood increases serotonin pool in rat medial frontal cortex. IRANIAN BIOMEDICAL JOURNAL 2013; 17:134-9. [PMID: 23748891 DOI: 10.6091/ibj.1173.2013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Ritalin has high tendency to be abused. It has been the main indication to control attention deficit hyperactivity disorder. The college students may seek for it to improve their memory, decrease the need for sleep (especially during exams), which at least partially, can be related to serotonergic system. Therefore, it seems worthy to evaluate the effect of Ritalin intake on mature brain. There are many studies on Ritalin effect on developing brain, but only few studies on adults are available. This study was undertaken to find Ritalin effect on serotonin transporter (SERT) density in medial frontal cortex (MFC) of mature rat. METHODS Thirty male Wistar rats were used in the study. Rats were assigned into five groups (n = 6 per group): one control, two Ritalin and two vehicle groups. Twelve rats received Ritalin (20 mg/kg/twice a day) orally for eleven continuous days. After one week of withdrawal and another two weeks of rest, in order to evaluate short-term effects of Ritalin, six rats were sacrificed. Another six rats were studied to detect the long-term effects of Ritalin; therefore, they were sacrificed 12 weeks after the previous group. The immunohistochemistry was performed to evaluate the results. RESULTS Immunohistochemistry studies showed a higher density of SERT in both 2 and 12 weeks after withdrawal from Ritalin intake in MFC of rat and there was no significant difference between these two groups. CONCLUSIONS Our findings demonstrated both short- and long-term effects of Ritalin on frontal serotonergic system after withdrawal period.
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Affiliation(s)
- Samira Daniali
- Dept. of Physiology, Faculty of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Zahra Madjd
- Dept. of Physiology, Faculty of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.,Physiology Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.,Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Shahbazi
- Oncopathology Research Center and Dept. of Pathology, Iran University of Medical Sciences, Tehran, Iran
| | - Somayeh Niknazar
- Dept. of Physiology, Faculty of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Delavar Shahbazzadeh
- Biotechnology Research Center, Dept. of Medical Biotechnology,
Venom and Toxin Unit, Pasteur Institute of Iran, Tehran, Iran
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The role of serotonin and cholesterol in asthma. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33:910-1; author reply 912-3. [PMID: 19348868 DOI: 10.1016/j.pnpbp.2009.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Accepted: 03/28/2009] [Indexed: 11/21/2022]
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Yuksel H, Sogut A, Yilmaz O. Attention deficit and hyperactivity symptoms in children with asthma. J Asthma 2008; 45:545-7. [PMID: 18773323 DOI: 10.1080/02770900801990016] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Asthma that is chronic may influence children's behavioral health and quality of life (QoL) negatively. OBJECTIVE To evaluate the frequency of attention deficit and hyperactivity symptoms in children with asthma and to determine if these symptoms are associated with a deterioration of QoL. METHODS Mothers of 62 children with moderate asthma and those of 38 healthy children aged between 7-12 years were included in the study. Conners' Parent Rating Scale-48 (CPRS), a 48-item multiple-choice questionnaire, was completed by the mothers to identify attention deficit and hyperactivity symptoms in children. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ) was filled in by children to measure QoL. RESULTS Mean age was 9.2 +/- 1.5 years for asthmatic children (37 male, 25 female) and 10.1 +/- 1.3 years for control group (20 male, 18 female). The two groups were similar regarding age and sex. Attention deficit score in the asthma group was significantly higher than that in the control group (p = 0.01). The frequency of hyperactivity was higher in the asthmatic group but the difference between the groups was not significant (p = 0.36). Attention deficit and hyperactivity scores of Conners-P were not correlated with PAQLQ scores (regarding total, activity, emotional and symptom domains). CONCLUSION Increased rates of attention deficit symptoms in children with asthma, as reported by mothers, might reflect the negative impact of asthma on neurobehavioral health. Asthmatic children, especially the ones who display attention deficit symptoms, must be considered for further evaluation regarding attention deficit hyperactivity disorder.
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Affiliation(s)
- Hasan Yuksel
- Pediatric Allergy and Pulmonology Unit, Celal Bayar University, Manisa, Turkey.
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Abstract
OBJECTIVE To determine the level of impulsivity of adolescents diagnosed as suffering from ADHD, Bronchial Asthma and Healthy adolescents (without any chronic disease). METHODS All participants (n=97) had completed the Barrett (Bis 10) questionnaire. RESULTS The adolescents suffering from Attention-deficit hyperactivity disorder (ADHD) scored the highest points 51.6; the control group without any chronic disease was second with 25.2 and the asthmatic adolescents were third with 23.4 points for their impulsivity. CONCLUSION It should be made clear to the people that the child comes in contact with his impulsive behavior is uncontrollable, and there is no justification for being angry with him nor any punishment. Patience and education is the answer. These adolescent should be under professional care in order to help him define more acceptable ways and means of deportment according to the norms and standards of his society.
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Affiliation(s)
- Uzi Brook
- Department of Pediatrics, Edith Wolfson Medical Center, Holon and Sackler Faculty of Medicine, Tel Aviv University, Israel.
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