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Advances in Medical Sciences

The Journal of Medical University of Bialystok

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Attention Deficit Hyperactivity Disorder and Increased Risk of Injury

R Merrill1 / J Lyon1 / R Baker1 / L Gren1

Department of Health Science, College of Health and Human Performance, Brigham Young University, Provo, Utah1

Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah2

Utah Department of Health, Division of Healthcare Finance, Bureau of Coverage and Reimbursement Policy, Salt Lake City, Utah3

This content is open access.

Citation Information: Advances in Medical Sciences. Volume 54, Issue 1, Pages 20–26, ISSN (Online) 1898-4002, ISSN (Print) 1896-1126, DOI: 10.2478/v10039-009-0022-7, July 2009

Publication History

Published Online:

Attention Deficit Hyperactivity Disorder and Increased Risk of Injury

Purpose: This study describes the influence of attention deficit hyperactivity disorder (ADHD) on the incidence rates of selected injuries.

Methods: A retrospective cohort study design was employed using medical claims data from the Deseret Mutual Benefit Administrators (DMBA), a health insurance company for employees of the Church of Jesus Christ of Latter-day Saints (LDS) and their spouses and dependent children. ADHD diagnosis, injury, medication, and demographic data were extracted from claims files during 1998-2005 for all enrollees aged 0-64 years.

Results: Incidence rates of ADHD were 1.83 (95% CI 1.68-2.00) times greater in males than females and highest in the age group 5-9 years and income group $80,000 or greater. ADHD increased the risk of selected injuries. The most common injuries involved sprains and strains of joints, then open wounds of the head, neck and trunk, and upper/lower limb, and then fractures of the upper/lower limb. Medication did not significantly protect against injury in ADHD patients. The rate of severe injury (i.e., fracture of skull, neck and trunk; intracranial injury excluding those with skull fracture; and injuries to nerves and spinal cord) was 3.07 (95% CI 2.37-3.98) times more common in ADHD enrollees compared with non-ADHD enrollees. Those with 1, 2, 3, or 4 or more injuries were 1.67 (1.50-1.86), 2.11 (1.75-2.56), 2.63 (1.80-3.84), and 2.94 (1.47-5.87) times more likely to have ADHD, respectively.

Conclusions: ADHD is positively associated with injuries. More severe injuries have a significantly stronger associated with ADHD than less severe injuries.

Keywords: ADHD; claims data; incidence; injury; retrospective cohort; risk

  • Mental health in the United States: Prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder. United States, 2003. MMWR. 2005;54(34):842-7.

  • Swensen A, Birnbaum HG, Ben Hamadi R, Greenberg P, Cremieux PY, Secnik K. Incidence and costs of accidents among attention-deficit/hyperactivity disorder patients. J Adolesc Health. 2004 Oct;35(4):346.e1-9.

  • Pastor PN, Reuben CA. Identified attention-deficit/hyperactivity disorder and medically attended, nonfatal injuries: US school-age children, 1997-2002. Ambul Pediatr. 2006 Jan-Feb;6(1):38-44.

  • Barkley RA, Guevremont DC, Anastopoulos AD, DuPaul GJ, Shelton TL. Driving-related risks and outcomes of attention deficit hyperactivity disorder in adolescents and young adults: a 3- to 5-year follow-up survey. Pediatrics. 1993 Aug;92(2):212-8.

  • DiScala C, Lescohier I, Barthel M, Li G. Injuries to children with attention deficit hyperactivity disorder. Pediatrics. 1998 Dec;102(6):1415-21. [CrossRef] [PubMed]

  • Farmer JE, Peterson L. Injury risk factors in children with attention deficit hyperactivity disorder. Health Psychol. 1995 Jul;14(4):325-32. [CrossRef] [PubMed]

  • Byrne JM, Bawden HN, Beattie T, DeWolfe NA. Risk for injury in preschoolers: relationship to attention deficit hyperactivity disorder. Child Neuropsychol. 2003 Jun;9(2):142-51. [CrossRef] [PubMed]

  • Thomas CR, Ayoub M, Rosenberg L, Robert RS, Meyer WJ. Attention deficit hyperactivity disorder & pediatric burn injury: a preliminary retrospective study. Burns. 2004 May;30(3):221-3. [CrossRef] [PubMed]

  • Wiśniewska B, Baranowska W, Wendorff J. The assessment of comorbid disorders in ADHD children and adolescents. Adv Med Sci. 2007;52 Suppl 1:215-7.

  • Kessler RC, Lane M, Stang PE, Van Brunt DL. The prevalence and workplace costs of adult attention deficit hyperactivity disorder in a large manufacturing firm. Psychol Med. 2009 Jan;39(1):137-47. [CrossRef] [Web of Science]

  • Kaya A, Taner Y, Guclu B, Taner E, Kaya Y, Bahcivan HG, Benli IT. Trauma and adult attention deficit hyperactivity disorder. J Int Med Res. 2008 Jan-Feb;36(1):9-16. [PubMed] [CrossRef]

  • International Classification of Diseases, 9th Revision, Clinical Modification, 4th ed., 3 vol. U.S. Department of Health and Human Services, October 1991.

  • Mantel N. Chi-square tests with one degree of freedom: extensions of the Mantel-Haenszel procedure. J Am Stat Assoc. 1963;58:690-700. - nie ma w pubmed

  • Daniels M, Merrill RM, Lyon JL, Stanford JB, White GL, Jr. Associations between breast cancer risk factors and religious practices in Utah. Prev Med. 2004 Jan;38(1):28-38. [CrossRef] [PubMed]

  • Merrill RM, Thygerson AL. Religious preference, church activity, and physical exercise. Prev Med. 2001 Jul;33(1):38-45. [CrossRef] [PubMed]

  • Merrill RM. Life expectancy among LDS and non- LDS in Utah. Demogr Res [Internet]. 2004 Mar 12 [cited 2008 Nov 18]; 10:61-82. Available from: http://www.demographicresearch.org/volumes/vol10/3/10-3.pdf [CrossRef]

  • Merrill RM, Lyon JL. Cancer incidence among Mormons and non-Mormons in Utah (United States) 1995-1999. Prev Med. 2005 May;40(5):535-41.

  • West DW, Lyon JL, Gardner JW. Cancer risk factors: an analysis of Utah Mormons and non-Mormons. J Natl Cancer Inst. 1980 Nov;65(5):1083-95.

  • Enstrom JE. Cancer and total mortality among active Mormons. Cancer. 1978 Oct;42(4):1943-51. [PubMed] [CrossRef]

  • Upadhyaya HP, Carpenter MJ. Is attention deficit hyperactivity disorder (ADHD) symptom severity associated with tobacco use? Am J Addict. 2008 May-Jun;17(3):195-8. [PubMed] [CrossRef]

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