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Shkalim Zemer V, Manor I, Weizman A, Cohen HA, Hoshen M, Menkes Caspi N, Cohen S, Faraone SV, Shahar N. The influence of COVID-19 on attention-deficit/hyperactivity disorder diagnosis and treatment rates across age, gender, and socioeconomic status: A 20-year national cohort study. Psychiatry Res 2024; 339:116077. [PMID: 39053214 DOI: 10.1016/j.psychres.2024.116077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 06/27/2024] [Accepted: 06/30/2024] [Indexed: 07/27/2024]
Abstract
Infection and lockdowns resulting from COVID-19 have been suggested to increase the prevalence and treatment rates of Attention Deficit/Hyperactivity Disorder (ADHD). To accurately estimate the pandemic's effects, pre-pandemic data can be used to estimate diagnosis and treatment rates during the COVID-19 years as if the COVID-19 pandemic did not occur. However, accurate predictions require a broad dataset, both in terms of the number of cases and the pre-pandemic timeframe. In the current study, we modeled monthly ADHD diagnosis and treatment rates over the 18 years preceding the COVID-19 pandemic. The dataset included ∼3 million cases for individuals aged 6 to 18 from the Clalit Health Services' electronic database. Using a trained model, we projected monthly rates for post-lockdown and post-infection periods, enabling us to estimate the expected diagnosis and treatment rates without the COVID-19 pandemic. We then compared these predictions to observed data, stratified by age groups, gender, and socioeconomic status. Our findings suggest no influence of the COVID-19 pandemic on ADHD diagnosis or treatment rates. We show that a narrower timeframe for pre-COVID-19 data points can lead to incorrect conclusions that COVID-19 affected ADHD diagnosis rates. Findings are discussed, given the assumed impact of the COVID-19 pandemic on ADHD.
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Affiliation(s)
- Vered Shkalim Zemer
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Dan-Petach-Tikva District, Clalit Health Services, Israel.
| | - Iris Manor
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Dan-Petach-Tikva District, Clalit Health Services, Israel; Geha Mental Health Center, Petah Tikva, Israel
| | - Abraham Weizman
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Dan-Petach-Tikva District, Clalit Health Services, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Herman Avner Cohen
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Ambulatory Community Clinic, Petach Tikva, Israel
| | - Moshe Hoshen
- Dan-Petach-Tikva District, Clalit Health Services, Israel; Bioinformatics Department, Jerusalem College of Technology, Jerusalem, Israel
| | | | - Shira Cohen
- Geha Mental Health Center, Petah Tikva, Israel
| | - Stephen V Faraone
- Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Nitzan Shahar
- The School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Kulkarni D, Ismail NF, Zhu F, Wang X, del Carmen Morales G, Srivastava A, Allen KE, Spinardi J, Rahman AE, Kyaw MH, Nair H. Epidemiology and clinical features of SARS-CoV-2 infection in children and adolescents in the pre-Omicron era: A global systematic review and meta-analysis. J Glob Health 2024; 14:05003. [PMID: 38419461 PMCID: PMC10902805 DOI: 10.7189/jogh.14.05003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Methods We searched MEDLINE, Embase, Global Health, CINAHL, China National Knowledge Infrastructure, Wanfang, CQvip, and the World Health Organization (WHO) COVID-19 global literature databases for primary studies recruiting children aged ≤18 years with a diagnosis of SARS-CoV-2 infection confirmed either by molecular or antigen tests. We used the Joanna Briggs Institute critical appraisal tools to appraise the study quality and conducted meta-analyses using the random effects model for all outcomes except for race/ethnicity as risk factors of SARS-CoV-2 infection. Results We included 237 studies, each reporting at least one of the study outcomes. Based on data from 117 studies, the pooled SARS-CoV-2 positivity rate was 9.30% (95% confidence interval (CI) = 7.15-11.73). Having a comorbidity was identified as a risk factor for SARS-CoV-2 infection (risk ratio (RR) = 1.33; 95% CI = 1.04-1.71) based on data from 49 studies. Most cases in this review presented with mild disease (n = 50; 52.47% (95% CI = 44.03-60.84)). However, 20.70% of paediatric SARS-CoV-2 infections were hospitalised (67 studies), 7.19% required oxygen support (57 studies), 4.26% required intensive care (93 studies), and 2.92% required assisted ventilation (63 studies). The case fatality ratio (n = 119) was 0.87% (95% CI = 0.54-1.28), which included in-hospital and out-of-hospital deaths. Conclusions Our data showed that children were at risk for SARS-CoV-2 infections and severe outcomes in the pre-Omicron era. These findings underscore the need for effective vaccination strategies for the paediatric population to protect against the acute and long-term sequelae of COVID-19. Registration PROSPERO: CRD42022327680.
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Affiliation(s)
- Durga Kulkarni
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Nabihah Farhana Ismail
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Communicable Disease Control Unit, Public Health Department, Johor State, Malaysia
| | - Fuyu Zhu
- Schol of Public Health, Nanjing Medical University, China
| | - Xin Wang
- Schol of Public Health, Nanjing Medical University, China
| | | | | | | | | | - Ahmed Ehsanur Rahman
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- International Centre for Diarrhoeal Diseases Research, Bangladesh
| | | | - Harish Nair
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Schol of Public Health, Nanjing Medical University, China
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Israel A, Merzon E, Krone B, Faraone SV, Green I, Golan Cohen A, Vinker S, Cohen S, Ashkenazi S, Magen E, Weizman A, Manor I. The Association Between Repeated Measured Febrile Episodes During Early Childhood and Attention Deficit Hyperactivity Disorder: A Large-Scale Population-Based Study. J Atten Disord 2024; 28:677-685. [PMID: 38281128 DOI: 10.1177/10870547231215289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2024]
Abstract
OBJECTIVE We examined the association between the number, magnitude, and frequency of febrile episodes during the 0 to 4 years of life and subsequent diagnosis of ADHD. METHODS This population-based case-control study in an Israeli HMO, Leumit Health Services (LHS), uses a database for all LHS members aged 5 to 18 years between 1/1/2002 and 1/30/2022. The number and magnitude of measured fever episodes during the 0 to 4 years were recorded in individuals with ADHD (N = 18,558) and individually matched non-ADHD controls in a 1:2 ratio (N = 37,116). RESULTS A significant, independent association was found between the number and magnitude of febrile episodes during the 0 to 4 years and the probability of a later diagnosis of ADHD. Children who never had a measured temperature >37.5°C had a significantly lower rate of ADHD (OR = 0.834, 95% CI [0.802, 0.866], p < .0001). CONCLUSIONS Febrile episodes during 0 to 4 years are associated with a significantly increased rate of a later diagnosis of ADHD in a doseresponse relationship.
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Affiliation(s)
- Ariel Israel
- Department of Epidemiology and Disease Prevention, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eugene Merzon
- Department of Epidemiology and Disease Prevention, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Beth Krone
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Ilan Green
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Shlomo Vinker
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Shai Ashkenazi
- Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Eli Magen
- Ben-Gurion University of the Negev Marcus Family Campus, Beer-Sheva, Israel
| | | | - Iris Manor
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Molero P, Reina G, Blom JD, Martínez-González MÁ, Reinken A, de Kloet ER, Molendijk ML. COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses. Epidemiol Psychiatr Sci 2023; 32:e61. [PMID: 37859501 PMCID: PMC10594644 DOI: 10.1017/s2045796023000719] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 10/21/2023] Open
Abstract
AIMS It has been suggested that people with mental disorders have an elevated risk to acquire severe acute respiratory syndrome coronavirus 2 and to be disproportionally affected by coronavirus disease 19 (COVID-19) once infected. We aimed to analyse the COVID-19 infection rate, course and outcome, including mortality and long COVID, in people with anxiety, depressive, neurodevelopmental, schizophrenia spectrum and substance use disorders relative to control subjects without these disorders. METHODS This study constitutes a preregistered systematic review and random-effects frequentist and Bayesian meta-analyses. Major databases were searched up until 27 June 2023. RESULTS Eighty-one original articles were included reporting 304 cross-sectional and prospective effect size estimates (median n per effect-size = 114837) regarding associations of interest. Infection risk was not significantly increased for any mental disorder that we investigated relative to samples of people without these disorders. The course of COVID-19, however, is relatively severe, and long COVID and COVID-19-related hospitalization are more likely in all patient samples that we investigated. The odds of dying from COVID-19 were high in people with most types of mental disorders, except for those with anxiety and neurodevelopmental disorders relative to non-patient samples (pooled ORs range, 1.26-2.57). Bayesian analyses confirmed the findings from the frequentist approach and complemented them with estimates of the strength of evidence. CONCLUSIONS Once infected, people with pre-existing mental disorders are at an elevated risk for a severe COVID-19 course and outcome, including long COVID and mortality, relative to people without pre-existing mental disorders, despite an infection risk not significantly increased.
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Affiliation(s)
- Patricio Molero
- Department of Psychiatry and Clinical Psychology, Clínica Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Gabriel Reina
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Microbiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Jan Dirk Blom
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Outpatient Clinic for Uncommon Psychiatric Syndromes, Parnassia Psychiatric Institute, The Hague, The Netherlands
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Miguel Ángel Martínez-González
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- CIBER-OBN, Instituto de Salud Carlos III, Madrid, Spain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Aischa Reinken
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - E. Ronald de Kloet
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Marc L. Molendijk
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
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Shkalim Zemer V, Hoshen M, Gerstein M, Richenberg Y, Jacobson E, Grossu R, Cohen M, Cohen HA. COVID-19 vaccine compliance in adolescents with attention-deficit/hyperactivity disorder. Int J Psychiatry Med 2023; 58:145-159. [PMID: 35940286 PMCID: PMC9364072 DOI: 10.1177/00912174221116734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To compare the rate of the administration of the Pfizer-BioNTech COVID-19 vaccinations between adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) and non-ADHD subjects. METHOD A retrospective chart review was performed on all adolescents aged 12-17 years registered at a central district in Israel from January 1st 2021 to October 31st 2021. RESULTS Of the 46,544 subjects included in the study, 8241 (17.7%) were diagnosed with ADHD. Of them, 3% were PCR-COVID-19 positive. Among the patients with ADHD, the older adolescents were more likely to be vaccinated: 48.8% of those aged 12-15 years were vaccinated versus 59.6% of patients aged 16-17 years. The ultra-orthodox Jewish and Arab adolescents in the ADHD group were far less likely to be vaccinated (22.9% and 34.6%, respectively), compared to the adolescents with ADHD in the general population (60.5%). Girls were also somewhat more likely to be vaccinated. CONCLUSIONS Adolescents diagnosed with ADHD had a higher COVID-19 vaccination rate compared to their non-ADHD counterparts. The vaccine uptake was lower amongst Arab and ultra-orthodox Jewish populations.
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Affiliation(s)
- Vered Shkalim Zemer
- Dan-Petach-Tikva District, Clalit Health Services, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Moshe Hoshen
- Dan-Petach-Tikva District, Clalit Health Services, Petach Tikva, Israel
| | - Maya Gerstein
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Pediatric Ambulatory Community Clinic, Petach Tikva, Israel
| | - Yael Richenberg
- Dan-Petach-Tikva District, Clalit Health Services, Petach Tikva, Israel
| | - Eyal Jacobson
- Dan-Petach-Tikva District, Clalit Health Services, Petach Tikva, Israel
| | - Roy Grossu
- Dan-Petach-Tikva District, Clalit Health Services, Petach Tikva, Israel
| | | | - Herman Avner Cohen
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Pediatric Ambulatory Community Clinic, Petach Tikva, Israel
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Heslin KP, Haruna A, George RA, Chen S, Nobel I, Anderson KB, Faraone SV, Zhang-James Y. Association Between ADHD and COVID-19 Infection and Clinical Outcomes: A Retrospective Cohort Study From Electronic Medical Records. J Atten Disord 2023; 27:169-181. [PMID: 36264064 PMCID: PMC9596686 DOI: 10.1177/10870547221129305] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Though psychiatric illnesses have been associated with increased COVID-19 infection risk, limited information exists about the relationship between ADHD and COVID-19. METHODS Using the TriNetX COVID-19 Research Network, we examined the impact of ADHD diagnosis and treatment on COVID-19 infection rates and outcomes. RESULTS ADHD patients had greater risk of COVID-19 (risk ratio (RR) 1.11, 95% CI [1.09, 1.12]). Increased risk was higher in females than males, and highest among Asian and Black patients. Within 60 days after COVID-19 diagnosis, ADHD patients had lower rates of hospitalization (RR 0.91, 95% CI [0.86, 0.96]) and mechanical ventilation (RR 0.69, 95% CI [0.58, 0.83]), and a nonsignificant reduced death rate (RR 0.65, 95% CI [0.42, 1.02]). Patients who recently received ADHD medication had higher rates of COVID-19 (RR 1.13; 95% CI [1.10, 1.15]). CONCLUSION ADHD poses increased risk for COVID-19, but may reduce risk of severe outcomes. ADHD medications modestly impacted COVID-19 risk.
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Affiliation(s)
- Kathleen P. Heslin
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Aminat Haruna
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Regina A. George
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Shiyu Chen
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ishak Nobel
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Kathryn B. Anderson
- Institute for Global Health and Translational Sciences, SUNY Upstate Medical University, Syracuse, New York
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, New York
| | - Stephen V. Faraone
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, New York
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York
| | - Yanli Zhang-James
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, New York
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Brill G, Manor I, Bril Paroz R, Ashkenazi S, Cohen S, Golan-Cohen A, Green I, Israel A, Vinker S, Weizman A, Merzon E. The Association between Somatotropin Therapy and the Risk of SARS-CoV-2 Infection in Children with Short Stature: A Population-Based Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121844. [PMID: 36553288 PMCID: PMC9777504 DOI: 10.3390/children9121844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022]
Abstract
COVID-19 is a worldwide pandemic caused by SARS-CoV-2, to which adults are usually more susceptible than children. Growth hormone (GH) levels differ between children and adults and decrease with age. There is bidirectional crosstalk between the GH/insulin-like growth factor-1 (IGF-1) pathway and the immune system that plays a significant role in SARS-CoV-2 infection. We evaluated the association between somatotropin treatment (GH replacement therapy) and the risk for SARS-CoV-2 positivity (a marker for COVID-19 infection) in children with growth hormone issues (GHI): growth hormone deficiency (GHD) and idiopathic short stature (ISS). A population-based cross-sectional study in Leumit Health Services (LHS) was performed using the electronic health record (EHR) database. The rates of SARS-CoV-2 positivity were evaluated among children with GHI, treated or untreated with somatotropin. Higher rates of SARS-CoV-2 positivity were found in GHI children, influenced by the same confounders reported in the pediatric population. A lower prevalence of SARS-CoV-2 PCR positivity was found among the somatotropin-treated children. A multivariate analysis documented that somatotropin treatment was associated with a reduced risk of SARS-CoV-2 positivity (Odds Ratio (OR) = 0.47, Confidence Interval (CI) 0.24-0.94, p = 0.032). Thus, somatotropin might be a protective factor against SARS-CoV-2 infections, possibly related to its immunomodulatory activity.
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Affiliation(s)
- Gherta Brill
- Pediatric Endocrinology Unit, Leumit Health Services, Tel-Aviv 6473817, Israel
| | - Iris Manor
- ADHD Unit, Geha Mental Health Center, Clalit Health Services, Petah Tikva 49100, Israel
- Department of Psychiatry, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Roberta Bril Paroz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Shai Ashkenazi
- Adelson School of Medicine, Ariel University, Ariel 4077625, Israel
| | - Shira Cohen
- ADHD Unit, Geha Mental Health Center, Clalit Health Services, Petah Tikva 49100, Israel
| | - Avivit Golan-Cohen
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Leumit Health Services, Medical Division, Tel Aviv 6473817, Israel
| | - Ilan Green
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Leumit Health Services, Medical Division, Tel Aviv 6473817, Israel
| | - Ariel Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Leumit Health Services, Medical Division, Tel Aviv 6473817, Israel
| | - Shlomo Vinker
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Leumit Health Services, Medical Division, Tel Aviv 6473817, Israel
| | - Abraham Weizman
- ADHD Unit, Geha Mental Health Center, Clalit Health Services, Petah Tikva 49100, Israel
- Department of Psychiatry, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence:
| | - Eugene Merzon
- Adelson School of Medicine, Ariel University, Ariel 4077625, Israel
- Leumit Health Services, Medical Division, Tel Aviv 6473817, Israel
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Kilic O, Boylu ME, Karakaya-Erdur S, Suma-Berberoglu M, Gudjonsson G, Young S, Deveci E, Kirpinar I. COVID-19 infection, vaccine status, and avoidance behaviors in adults with attention deficit and hyperactivity disorder: A cross-sectional study. Front Psychiatry 2022; 13:938111. [PMID: 36090380 PMCID: PMC9450559 DOI: 10.3389/fpsyt.2022.938111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Objective We aim to examine infection risk and vaccine status of COVID-19 in attention deficit and hyperactivity disorder and evaluate the impact of demographic, clinical, and COVID-19-related factors on the infection status and behavioral avoidance of COVID-19. Methods This cross-sectional study assessed adults with attention deficit and hyperactivity disorder recruited from an outpatient psychiatry clinic. Patients and healthy controls completed a survey on sociodemographic data, COVID-19 infection status, and vaccine status. COVID-19 Disease Perception Scale, COVID-19 Avoidance Attitudes Scale, Attitudes toward COVID-19 Vaccine Scale, Adult Attention Deficit and Hyperactivity Disorder Self-report Screening Scale for DSM-5, Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale Symptoms Checklist, Patient Health Questionnaire-9, and State-Trait Anxiety Inventory were applied. Results Ninety patients and 40 healthy controls participated. Patients did not differ from controls in COVID-19 infection and vaccine status, and behavioral avoidance of COVID-19. No demographic and clinical factor significantly affected the COVID-19 infection status. Patients scored higher than controls in the perception of COVID-19 as contagious (p = 0.038), cognitive avoidance of COVID-19 (p = 0.008), and positive attitudes toward the COVID-19 vaccine (p = 0.024). After adjustment of possible factors, a positive perception of the COVID-19 vaccine and a perception of COVID-19 as dangerous were the two factors significantly affecting behavioral avoidance of COVID-19 [R 2 = 0. 17, F(2) = 13.189, p < 0.0001]. Conclusion Infection and vaccine status of COVID-19 in patients did not significantly differ from controls. No demographic and clinical factor significantly affected the COVID-19 infection status. Approximately four-fifths of the patients were fully vaccinated as recommended by national and global health organizations. This has increased the knowledge base showing that the COVID-19 vaccine is acceptable and receiving the vaccine is endorsed by ADHD patients. Attention deficit and hyperactivity disorder itself may provoke no kind of mental disturbance in sense of perception of the danger of this disease. Our findings have increased the knowledge base showing that the COVID-19 vaccine is acceptable and the actual practice of receiving the vaccine is endorsed in this population. Our message for practice would be to take into account not only the core symptoms and the comorbidities of the disorder but also the perception of the disease while exploring its link with COVID-19.
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Affiliation(s)
- Ozge Kilic
- Department of Psychiatry, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Muhammed Emin Boylu
- Department of Psychiatry, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Sila Karakaya-Erdur
- Department of Psychiatry, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Gisli Gudjonsson
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Susan Young
- Department of Psychology, Reykjavík University, Reykjavik, Iceland
| | - Erdem Deveci
- Department of Psychiatry, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ismet Kirpinar
- Department of Psychiatry, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Merzon E, Weiss M, Krone B, Cohen S, Ilani G, Vinker S, Cohen-Golan A, Green I, Israel A, Schneider T, Ashkenazi S, Weizman A, Manor I. Clinical and Socio-Demographic Variables Associated with the Diagnosis of Long COVID Syndrome in Youth: A Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5993. [PMID: 35627530 PMCID: PMC9141083 DOI: 10.3390/ijerph19105993] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 02/01/2023]
Abstract
This study examines the demographic, clinical and socioeconomic factors associated with diagnosis of long COVID syndrome (LCS). Data of 20,601 COVID-19-positive children aged 5 to 18 years were collected between 2020 and 2021 in an Israeli database. Logistic regression analysis was used to evaluate the adjusted odds ratio for the characteristics of the COVID-19 infection and pre-COVID-19 morbidities. Children with LCS were significantly more likely to have been severely symptomatic, required hospitalization, and experienced recurrent acute infection within 180 days. In addition, children with LCS were significantly more likely to have had ADHD, chronic urticaria, and allergic rhinitis. Diagnosis of LCS is significantly associated with pre-COVID-19 ADHD diagnosis, suggesting clinicians treating ADHD children who become infected with COVID-19 remain vigilant for the possibility of LCS. Although the risk of severe COVID-19 infection and LCS in children is low, further research on possible morbidity related to LCS in children is needed.
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Affiliation(s)
- Eugene Merzon
- Leumit Health Services, Tel-Aviv 6473817, Israel; (E.M.); (S.V.); (A.C.-G.); (I.G.); (A.I.)
- Adelson School of Medicine, Ariel University, Ariel 4076414, Israel;
| | | | - Beth Krone
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Shira Cohen
- ADHD Unit, Geha Mental Health Center, Petah Tikva 49100, Israel; (A.W.); (I.M.)
| | - Gili Ilani
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Shlomo Vinker
- Leumit Health Services, Tel-Aviv 6473817, Israel; (E.M.); (S.V.); (A.C.-G.); (I.G.); (A.I.)
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Avivit Cohen-Golan
- Leumit Health Services, Tel-Aviv 6473817, Israel; (E.M.); (S.V.); (A.C.-G.); (I.G.); (A.I.)
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Ilan Green
- Leumit Health Services, Tel-Aviv 6473817, Israel; (E.M.); (S.V.); (A.C.-G.); (I.G.); (A.I.)
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Ariel Israel
- Leumit Health Services, Tel-Aviv 6473817, Israel; (E.M.); (S.V.); (A.C.-G.); (I.G.); (A.I.)
| | | | - Shai Ashkenazi
- Adelson School of Medicine, Ariel University, Ariel 4076414, Israel;
| | - Abraham Weizman
- ADHD Unit, Geha Mental Health Center, Petah Tikva 49100, Israel; (A.W.); (I.M.)
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Iris Manor
- ADHD Unit, Geha Mental Health Center, Petah Tikva 49100, Israel; (A.W.); (I.M.)
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
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