Risk of Respiratory Infectious Diseases and the Role of Methylphenidate in Children with Attention-Deficit/Hyperactivity Disorder: A Population-Based Cohort Study.

Dian-Jeng Li,Ray C Hsiao,Hsiu-Lin Chen,Yi-Lung Chen,Cheng-Fang Yen

doi:10.3390/ijerph18115824

Abstract

Children with attention-deficit/hyperactivity disorder (ADHD) are commonly affected by medical illness. The aim of the present study was to explore the risks of contracting respiratory infectious diseases (RIDs), including upper and lower RIDs and influenza, in children with ADHD. We also examined whether methylphenidate has a protective effect regarding the risk of contracting RIDs among children with ADHD who have a history of methylphenidate treatment. Children in the Taiwan Maternal and Child Health Database from 2004 to 2016 were included in the present study. Upper and lower RIDs, influenza, ADHD, age, sex, and records of methylphenidate prescription were identified. A Cox proportional hazards regression model was used to estimate the significance of the risk of RIDs among children with ADHD in comparison with that among children without ADHD after adjustment for sex and age. The self-controlled case series analysis was conducted to examine the protective effect of methylphenidate treatment against RIDs. In total, 85,853 children with ADHD and 1,458,750 children without ADHD were included in the study. After controlling for sociodemographic variables, we observed that children with ADHD had significantly higher risks of upper RIDs, lower RIDs, and influenza infection than did those without ADHD. Among the children with ADHD who had a history of methylphenidate treatment, the risk of contracting RIDs was lower during the methylphenidate treatment period than during the nontreatment period. Children with ADHD had a higher RID risk than those without ADHD. Methylphenidate might reduce the risk of RIDs among children with ADHD who have a history of methylphenidate treatment.

Highlights

We discovered that the children with attention-deficit/hyperactivity disorder (ADHD) had lower average risks for upper respiratory infectious diseases (RIDs) (RR, 0.47; 95% confidence intervals (CIs), 0.40–0.55), as well as for lower RIDs
Other research has explored the association between ADHD and the risk of COVID-19 infection [18], the present study further extends the knowledge of this association to various types of
The present study reveals that children with ADHD have increased risks of contracting upper RIDs, lower RIDs, and influenza compared with those without ADHD

Summary

Introduction

Association between Attention-Deficit/Hyperactivity Disorder and Medical Comorbidities. Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder and manifests as hyperactivity, inattentiveness, and impulsivity [1,2]. The lifetime prevalence of ADHD within children in Taiwan was reported to be up to 10.1% [4]. Individuals with ADHD are at greater risk of various mental health–related comorbidities, such as suicidality [7], depression [8], and substance abuse [9]. In additional to mental disorders, ADHD is often comorbid with medical illnesses. Research has demonstrated that medical illnesses in individuals with ADHD are widespread across different physical categories, such as cardiovascular, immunological, neurological, and gastroenterological diseases [12,13]. The relationship between ADHD and medical comorbidities is not fully understood, it highlights an urgent requirement for multidisciplinary medical services for children with

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