Patterns of Injuries Among Children Diagnosed With Attention Deficit Hyperactivity Disorder in Aseer Region, Southwestern Saudi Arabia

Breaking It Down: A Systematic Review Unravelling the Impact of Attention Deficit Hyperactivity Disorder and Methylphenidate on Childhood Fractures

Limb fractures are a common cause of pediatric hospital admissions and surgeries, with a significant prevalence in the United Kingdom across all injury categories. Among psychiatric conditions in children, attention deficit hyperactivity disorder (ADHD) stands out as frequently associated with fractures, particularly those involving extremities. ADHD, with diagnoses prevalent among a significant proportion of school-age children and adolescents, has witnessed a growing global incidence. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist for our systematic literature search, using various databases and specific search terms related to ADHD and fractures. We considered articles from 2018 to 2023, focusing on English language papers with free full-text access. Our selection process used the PRISMA flowchart. We began with 1,890 articles and, after deduplication, title screening, abstract assessment, and quality evaluation included nine research papers in our review. Our primary focus was on examining fracture-related outcomes in individuals with ADHD compared to those without, considering medication status. These studies encompassed various designs, with a focus on the ADHD-fracture relationship and methylphenidate's (MPH) impact. Our study confirms that ADHD increases fracture risk and suggests that MPH may help mitigate this risk. Early ADHD detection is vital for nonpharmacological interventions. Orthopedic surgeons should proactively identify ADHD, while healthcare professionals should offer injury prevention guidance, particularly for at-risk groups.

Prevalence of Attention Deficit Hyperactivity Disorder Among Children in Makkah Region, Saudi Arabia

Introduction Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in children and is described as a disease involving loss of self-control. The core symptoms of ADHD are inattentiveness, impulsivity, and motor unrest. Furthermore, poor concentration, distraction, hyperactivity, and poor academic achievement at school or at home are other symptoms. ADHD, like other prevalent medical disorders such as asthma and schizophrenia, may be impacted by several genes and has multiple contributing causes that are not all related to each other. The management of ADHD contains multimodal treatments, starting with psycho-education for parents and the child or adolescent patient in an age-appropriate manner called cognitive behavioral therapy. The worldwide prevalence rate of ADHD among children is 7.2% and, in some countries, can be higher and reach 15.5%; studies show the average prevalence of ADHD in the Kingdom of Saudi Arabia (KSA) is 9.2%. Method A descriptive cross-sectional study was conducted from December 2022 to January 2023 among children who live in Makkah between the ages of 4 and 14 years old via an online survey that contained the ADHD Rating Scale-IV for parents/teachers, and caregivers based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria. The scale was translated into Arabic and contains 18 questions about ADHD symptoms. Result The overall prevalence of combined ADHD among children in Makkah is 52.5% (n=203 out of 387); most of them were males (30.8%) and 21.7% were females (P=0.09), and most of the combined ADHD prevalence was between the ages of 11 and 14 (20.4%), then the age of 4-7 (16.8%), and 15.3% of them were between 8 and 10 years old. Additionally, the results show a higher prevalence of combined ADHD in Makkah city (33.1%) (n=121) in comparison to rural areas 19.4% (n=82) (P=0.132). Conclusion The aim of the study was to measure the prevalence rate of ADHD in the Makkah region. The study showed a high prevalence rate of ADHD (52.5%) among children in Makkah; the study was carried out online using an ADHD scale, and more accurate results could be found by using face-to-face interviews and including both parents and teachers.

Relationship between Injuries and Attention-Deficit Hyperactivity Disorder: A Population-Based Study with Long-Term Follow-Up in Taiwan

Objective: To investigate the association between various injuries and attention-deficit hyperactivity disorder (ADHD) and distinguish ADHD from non-ADHD with regards to risk of various injuries among children in Taiwan. Method: Using the data from the National Health Insurance Research Database, we selected a total of 1802 subjects under the age of 18 who were diagnosed with ADHD as well as an additional 7208 subjects as a comparison group. Results: Compared with children who were not diagnosed with ADHD, children diagnosed with ADHD were more likely to intentionally injure themselves. During the school year, ADHD children were injured less frequently than were non-ADHD children on traffic-related incidents. The adjusted hazard ratio of injury for the ADHD children was 2.493 times higher than that of comparison subjects. The ADHD children had a greater length of stay and medical cost when compared to those of the non-ADHD children. Age showed a significant inverse relationship with injury. Among the ADHD children, the injury rate was evidently higher for the low-income group than for the non-low-income group. Conclusions: Age, cause of injuries, low-income household status, and school season all have a significant connection to the risk of injury for ADHD children.