Frequent Pain is Common Among 10-11-Year-Old Children with Symptoms of Attention Deficit Hyperactivity Disorder

Abstract

Sara S Berggren,1,2 Stefan Bergman,3,4 Gerd Almquist-Tangen,1,5 Jovanna Dahlgren,1,6 Josefine Roswall,1,5 Julia S Malmborg4,7 1Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2Health Center Hyltebruk, Halland, Sweden; 3General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 4Spenshult Research and Development Centre, Halmstad, Sweden; 5Department of Pediatrics, Halland Hospital Halmstad, Halmstad, Sweden; 6Västra Götaland County, Department of Pediatrics, Queen Silvia Children’s Hospital, Gothenburg, Sweden; 7School of Health and Welfare, Halmstad University, Halmstad, SwedenCorrespondence: Sara S Berggren, Email [email protected]: Adults with neurodevelopmental disorders have an increased risk for chronic pain. This study aimed to describe the prevalence of frequent and multisite pain among children with symptoms of attention deficit hyperactivity disorder (ADHD) and explore potential sex differences in pain prevalence.Participants and Methods: Children born in 2008 included in the “Halland Health and Growth Study” were invited to a follow-up (n = 1186) in 2018– 19. Parents received a digital screening questionnaire, the Swanson, Nolan and Pelham Rating Scale (SNAP-IV) for ADHD, and the children answered a pain questionnaire that included a pain mannequin. The main outcome was pain experience, and children with symptoms of ADHD were compared to children without these symptoms.Results: In this general population of 10– 11-year-old Swedish children, weekly pain was reported in 52.5% of children with symptoms of ADHD combined type, compared to 36.2% of children without these symptoms (p < 0.05). Hyperactivity and impulsivity were significant contributors to the increased risk for frequent pain (OR 2.33 95% CI 1.30 to 4.17, p = 0.004), but inattention was not a significant contributor (OR 1.17 95% CI 0.74 to 1.87, p = 0.497). Multisite pain was more common among girls with hyperactivity compared to boys with hyperactivity (51.4 vs 27.9%, p = 0.036). Weekly headache and/or abdominal pain was reported by a quarter of girls with symptoms of ADHD combined type, and up to a fifth of boys, compared to 11– 13% of children without these symptoms.Conclusion: Frequent pain was more common for children with symptoms of ADHD compared to children without symptoms of ADHD. Hyperactivity and impulsivity had a stronger association to pain than had inattention-related problems. Clinicians should be aware of the frequent occurrence and the association between pain and neurodevelopmental disorders among children, and that it could complicate both the clinical picture and the treatment.Keywords: attention deficit hyperactivity disorder, ADHD, birth cohort, children, multisite pain, sex differences

Keywords

• attention deficit hyperactivity disorder
• adhd
• birth cohort
• children
• multisite pain
• sex differences