Abstract
Studies in the field of neuroscience and psychology have hypothesized that a causal association exists between atopic diseases and attention-deficit/hyperactivity disorder (ADHD). Previous systematic reviews and meta-analyses have reported a higher risk of ADHD in children with atopic diseases; however, the relationship between ADHD symptoms and atopic diseases remains unclear. We systematically reviewed observational cross-sectional and longitudinal studies to investigate the relationship between atopic diseases and ADHD symptom severity (hyperactivity/impulsivity and inattention). The majority of studies showed a statistically significant association between atopic diseases and both ADHD symptoms, with substantial heterogeneity in the outcome of hyperactivity/impulsivity. Remarkably decreased heterogeneity and statistical significance were observed in the second meta-analysis of ADHD-related behavior symptoms in atopic patients without ADHD. Our study indicated that atopic diseases not only associated with ADHD but also ADHD symptoms severity. This association was even observed in children with subthreshold ADHD, indicating that atopic diseases may play a role in the spectrum of ADHD symptom severity. Trial registration: This study was registered on PROSPERO (registration ID: CRD42020213219).
Highlights
Studies in the field of neuroscience and psychology have hypothesized that a causal association exists between atopic diseases and attention-deficit/hyperactivity disorder (ADHD)
The results of the subgroup analysis indicated that children with subthreshold ADHD in the atopic disease groups had increased severity of ADHD symptoms, including total ADHD symptoms, hyperactivity/impulsivity, and inattention, and atopic dermatitis and allergic rhinitis were significantly associated with ADHD symptoms
Our results suggested that children with atopic diseases without previous ADHD diagnosis had a stronger association of more severe core symptoms of ADHD than healthy unexposed groups, indicating a more consistent result for inattention than hyperactivity/impulsivity, with remarkably decreased heterogeneity
Summary
Studies in the field of neuroscience and psychology have hypothesized that a causal association exists between atopic diseases and attention-deficit/hyperactivity disorder (ADHD). Previous systematic reviews and meta-analyses have reported a higher risk of ADHD in children with atopic diseases; the relationship between ADHD symptoms and atopic diseases remains unclear. We systematically reviewed observational cross-sectional and longitudinal studies to investigate the relationship between atopic diseases and ADHD symptom severity (hyperactivity/impulsivity and inattention). Decreased heterogeneity and statistical significance were observed in the second meta-analysis of ADHD-related behavior symptoms in atopic patients without ADHD. Adult patients with ADHD experience a financial burden and may even require considerable s upport[14] These findings indicate that ADHD is a matter of considerable concern in child and adolescent psychiatry. No systematic review and meta-analysis has examined whether atopic diseases affect the severity of both hyperactivity/impulsivity and inattention—the two main symptoms and diagnostic criteria related to ADHD
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