Abstract
ObjectiveThe study aims to determine the demographic predictors of attention-deficit/hyperactivity disorder (ADHD) in hospitalized children with autism spectrum disorder (ASD) and the impact of comorbidities on the length of stay (LOS).MethodsA retrospective study was performed using a nationwide inpatient sample from US hospitals. All patients were ≤18 years in age with a primary diagnosis of ASD (n = 3,095) and grouped by co-diagnosis of ADHD based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes. Logistic regression was used to calculate the odds ratio (OR) and linear regression for estimated LOS.ResultsMale patients had a higher odds of comorbid ADHD (OR: 2.2). Age and race were not significant predictors of ADHD though the condition was found to be prevalent in adolescents and Caucasians. These children were mainly from the South (30.8%) and the Midwest (29.9%) regions of the US. Psychosis was seen in 37.3% of patients with ADHD and was more likely to be comorbid psychosis (OR: 1.8). Depression and ADHD increased the LOS in hospitals for ASD by 2.1 days and 0.9 days, respectively.ConclusionOur study led us to determine the demographic predictors of comorbid ADHD in patients with autism, and we believe that our findings can help to better serve these patients and their families. Comorbid ADHD and depression can prolong the length of hospitalization and they necessitate the need for acute inpatient care in such patients.
Highlights
Autism spectrum disorder (ASD) is a lifelong, pediatric neurodevelopmental disorder characterized by marked impairments in socialization, communication, and the presence of restricted, repetitive behaviors or interests [1]
The study aims to determine the demographic predictors of attention-deficit/hyperactivity disorder (ADHD) in hospitalized children with autism spectrum disorder (ASD) and the impact of comorbidities on the length of stay (LOS)
Our study led us to determine the demographic predictors of comorbid ADHD in patients with autism, and we believe that our findings can help to better serve these patients and their families
Summary
Autism spectrum disorder (ASD) is a lifelong, pediatric neurodevelopmental disorder characterized by marked impairments in socialization, communication, and the presence of restricted, repetitive behaviors or interests [1]. In children diagnosed with ASD, 59% suffer from attention-deficit/hyperactivity disorder (ADHD). Even though ASD and ADHD are separate conditions, there is an overlap in their disease presentations [3]. Similar abnormalities in the gray matter volume of ASD and ADHD patients have been observed. This could be one of the possible neurobiological basis for the overlapping symptoms of inattention, poor executive function, hyperactivity, and issues with social interaction [3]. Due to the presence of ADHD symptoms in both conditions, a diagnosis of autism is sometimes delayed or misidentified [4]
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