Abstract
The rise in atopic dermatitis (AD) has been paralleled by rising prevalence of attention deficit/hyperactivity disorder (ADHD) in the past few decades, especially in developed and Western countries. Previous research shows a possible association between AD and ADHD, but data have been mixed, likely due to poorly defined phenotypes and heterogeneity in measuring AD and ADHD. Furthermore, most studies have been limited by cross-sectional designs. To test our hypothesis that active and more severe early childhood AD is associated with clinician-diagnosed ADHD at age 7, and hyperactive symptoms as measured by the Strengths and Difficulties Questionnaire (SDQ) at ages 7, 10, 13, and 16 years, we analyzed data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large population-based birth cohort from the UK. Using logistic regression models, we found that AD (defined as at least two reports of flexural dermatitis from a standardized and validated questionnaire) was not associated with clinician-diagnosed ADHD at age 7 based on the Development and Wellbeing Assessment (Odds Ratio 1.07, 95% CI 0.64-1.78, adjusted for potential confounders including maternal stress during pregnancy, maternal age at delivery, maternal smoking during pregnancy, socioeconomic status, and maternal smoking). We found a trend toward higher effect estimates in younger ages, though this was not statistically significant, and we found no evidence of an interaction with parental-reported sleep quantity. Additionally, we did not find any significant cross-sectional associations between active AD and symptoms of hyperactivity based on the SDQ at four subsequent assessments between ages 7 and 16. Our results do not provide evidence to support an association between AD and ADHD in a large cohort of children followed from birth. Our research challenges the current paradigm that AD is strongly associated with ADHD.
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