Neuropsychiatric Disease and Treatment (May 2020)
Association Between Attention Deficit Hyperactivity Disorder and Risk of Burn Injury: A Propensity-Matched Cohort Study
Abstract
Jia-Yin Yeh,1 Tsai-Yu Hou,1 Wei-Ting Tseng,1 Vincent Chin-Hung Chen,2,3 Yao-Hsu Yang,4,5 Ting-Yu Kuo,4 Jun-Cheng Weng,6,7 Charles Tzu-Chi Lee,8 Yi-Lung Chen,9,10 Min-Jing Lee2,3 1Department of Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Branch, Kaohsiung, Taiwan; 2Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 3School of Medicine, Chang Gung University, Taoyuan, Taiwan; 4Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 5Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 6Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; 7Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 8Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan; 9Department of Healthcare Administration, Asia University, Taichung, Taiwan; 10Department of Psychology, Asia University, Taichung, TaiwanCorrespondence: Min-Jing LeeDepartment of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan, No. 6, W. Sec., Jiapu Road, Puzi City, Chiayi County 613, TaiwanTel +886-5-3621000 ext2303Fax +886-5-3622188Email [email protected]: Literature suggests that attention deficit hyperactivity disorder (ADHD) is associated with a high risk of unintentional injury. However, few studies have focused on whether risk of burn injury is relatively high among patients with ADHD. The aim of this study was to investigate whether ADHD affects the risk of burn injury.Materials and Methods: Individuals aged < 18 years with a current diagnosis of ADHD (N = 52,705) and age-, sex-, and other comorbidity-matched controls were selected from Taiwan’s National Health Insurance Research Database for the period of January 1996 to December 2013. Burn injury was identified in both groups, and risk was evaluated using Cox proportional hazards models. We also explored the effects of age and sex on the association.Results: We determined that patients with ADHD had an increased probability of burn injury compared with the control group (ADHD vs controls, 4.6% vs 2.6%; adjusted hazard ratio [aHR] = 1.78; 95% confidence interval [CI] = 1.66– 1.90). The effect of ADHD on burn injury was more prominent among those aged < 6 years (aHR = 1.96; 95% CI = 1.75– 2.20) relative to those aged ≥ 6 years (aHR = 1.69; 95% CI = 1.56– 1.83). Both sexes had similar risk profiles.Conclusion: The study findings contribute to the increasing body of evidence that ADHD is associated with proneness to burn injury, particularly in children aged < 6 years.Keywords: ADHD, burn injury, propensity-matched, cohort