Abstract
BackgroundThe objective of this study was to examine the impact of co-occurring social and emotional difficulties on missed school days and healthcare utilization among children with attention deficit/hyperactivity disorder (ADHD).MethodsData were from the 2007 U.S. National Health Interview Survey (NHIS) and were based on parental proxy responses to questions in the Sample Child Core, which includes questions on demographics, health, healthcare treatment, and social and emotional status as measured by questions about depression, anxiety, and phobias, as well as items from the brief version of the Strength and Difficulties Questionnaire (SDQ). Logistic regression was used to assess the association between co-occurring social and emotional difficulties with missed school days and healthcare utilization, adjusting for demographics.ResultsOf the 5896 children aged 6–17 years in the 2007 NHIS, 432 (7.3%) had ADHD, based on parental report. Children with ADHD and comorbid depression, anxiety, or phobias had significantly greater odds of experiencing > 2 weeks of missed school days, ≥ 6 visits to a healthcare provider (HCP), and ≥ 2 visits to the ER, compared with ADHD children without those comorbidities (OR range: 2.1 to 10.4). Significantly greater odds of missed school days, HCP visits, and ER visits were also experienced by children with ADHD who were worried, unhappy/depressed, or having emotional difficulties as assessed by the SDQ, compared with ADHD children without those difficulties (OR range: 2.2 to 4.4).ConclusionsIn children with ADHD, the presence of social and emotional problems resulted in greater odds of missed school days and healthcare utilization. These findings should be viewed in light of the limited nature of the parent-report measures used to assess social and emotional problems.
Highlights
The objective of this study was to examine the impact of co-occurring social and emotional difficulties on missed school days and healthcare utilization among children with attention deficit/hyperactivity disorder (ADHD)
Of the 5896 children aged 6–17 years in the 2007 National Health Interview Survey (NHIS), 432 (7.3%) had ADHD based on parental reports
Compared with a reported formal diagnosis, a higher percentage of parents reported that their ADHD child was unhappy or depressed (27.4%) or often seemed worried (47.3%)
Summary
The objective of this study was to examine the impact of co-occurring social and emotional difficulties on missed school days and healthcare utilization among children with attention deficit/hyperactivity disorder (ADHD). Mild difficulties may fail to come to clinical attention, while in other cases such difficulties can contribute to overt, physician-diagnosed, comorbid mental health disorders, including anxiety, depression, and conduct disorder [22,23,24]. Comorbid mental health conditions, including anxiety and depression, are extremely typical among children with ADHD and have been shown to be associated with greater functional impairment and worse educational outcomes [29,30,31,32,33]
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