The online version of this article (doi:10.1186/s12888-017-1281-7) contains supplementary material, which is available to authorized users.
Reports of frequent manifestation of allergic diseases in children with attention deficit hyperactivity disorder (ADHD) have been the subject of mounting clinical interest. However, evidence supporting the association between ADHD and allergies is inconsistent and has yet to be systematically reviewed. The objective of this study was to compile and assess available studies on the association between ADHD and allergic diseases in children.
A comprehensive search using MEDLINE, EMBASE, the Cochrane library, and CINAHL databases was completed in 23 November 2015. The inclusion criteria for studies were that the research assessed allergic diseases in children, 18 years of age and younger, with a diagnosis of ADHD and that a distinct comparison group was incorporated. Any comparative studies, encompassing both randomized controlled trials and observational studies, were considered for inclusion. Two review authors independently assessed the quality of the selected studies by the use of validated assessment tools, performed data extraction and conducted meta-analysis according to Cochrane Collaboration guidelines.
Five eligible studies were included in this systematic review. Of these studies, three were case-control and two were cross sectional studies. A majority of information from the five studies was classified as having low or unclear risk of bias. The meta-analysis showed an association between children with ADHD and asthma compared with the control groups (OR: 1.80, 95% CI: 1.57 - 2.07; five studies, low quality of evidence), but did not indicate an association between food allergy and ADHD (OR: 1.13, 95% CI: 0.88 - 1.47; three studies very low quality of evidence). The odds of experiencing allergic rhinitis, atopic dermatitis, and allergic conjunctivitis were slightly higher in children with ADHD compared with control groups, though a substantial statistical heterogeneity was notable in the overall effect estimates.
The findings from this review and meta-analysis show that children with ADHD are more likely to have asthma, allergic rhinitis, atopic dermatitis, and allergic conjunctivitis than their counterparts. Interventions including strategies for managing allergies in children with ADHD would be beneficial.
Additional file 1: PRISMA checklist. (DOCX 38 kb)12888_2017_1281_MOESM1_ESM.docx
Additional file 2: Search strategy. (DOCX 20 kb)12888_2017_1281_MOESM2_ESM.docx
Additional file 3: Excluded studies with reasons for exclusion. (DOCX 145 kb)12888_2017_1281_MOESM3_ESM.docx
Additional file 4: Risk of bias assessment within studies. (DOCX 134 kb)12888_2017_1281_MOESM4_ESM.docx
Additional file 5: Summary of results on allergic diseases in children with ADHD. (DOCX 22 kb)12888_2017_1281_MOESM5_ESM.docx
Additional file 6: Summary of evidence quality based on GRADE approach. (DOCX 130 kb)12888_2017_1281_MOESM6_ESM.docx
American Psychiatric Association. Diagnostic and statistical manual of mental disorders 5th ed. Washington: American Psychiatric Association Press; 2013. CrossRef
Wigal SB, McGough JJ, McCracken JT, Biederman J, Spencer TJ, Posner KL, Wigal TL, Kollins SH, Clark TM, Mays DA, et al. A laboratory school comparison of mixed amphetamine salts extended release (Adderall XR) and atomoxetine (Strattera) in school-aged children with attention deficit/hyperactivity disorder. J Atten Disord. 2005;9(1):275–89. CrossRefPubMed
Lee YH, Song GG. Meta-analysis of case-control and family-based associations between the 5-HTTLPR L/S polymorphism and susceptibility to ADHD. J Atten Disord. 2015
Miyazaki C, Koyama M, Ota E, Swa T, Amiya RM, Mlunde LB, Tachibana Y, Yamamoto-Hanada K, Mori R. Allergies in children with autism spectrum disorder: a systematic review and meta-analysis. Rev J Autism Dev Disord. 2015;2(4):374–401. CrossRef
Gillberg C, Gillberg IC, Rasmussen P, Kadesjö B, Söderström H, Råstam M, Johnson M, Rothenberger A, Niklasson L. Co–existing disorders in ADHD – implications for diagnosis and intervention. Eur Child Adolesc Psychiatry. 2004;13(Suppl 1):i80–92. PubMed
Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management, Wolraich M, Brown L, Brown RT, DuPaul G, Earls M, Feldman HM, Ganiats TG, Kaplanek B, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics 2011; 128(5):1007-1022.
Schmitt J, Apfelbacher C, Chen C-M, Romanos M, Sausenthaler S, Koletzko S, Bauer C-P, Hoffmann U, Krämer U, Berdel D, et al. Infant-onset eczema in relation to mental health problems at age 10 years: results from a prospective birth cohort study (German Infant Nutrition Intervention plus). J Allergy Clin Immunol. 2010;125(2):404–10. CrossRefPubMed
Boris M, Goldblatt A. Pollen exposure as a cause for the deterioration of neurobehavioral function in children with autism and attention deficit hyperactive disorder: nasal pollen challenge. J Nutr Environ Med. 2004;14(1):47–54. CrossRef
Higgins J, Green S. Cochrane handbook for systematic reviews of interventions version 5.1. 0 [Updated 2011]. The Cochrane Collaboration:2011. http://handbook.cochrane.org. Accessed 15 December 2015
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Internal Med. 2009;151(4):264–9. CrossRef
American Psychiatric Association. Diagnostic and statistical manual of mental disorders text-revision 4th ed. Washington: American Psychiatric Association Press; 2000.
National Institute for Health and Clinical Excellence. Attention deficit hyperactivity disorder: diagnosis and management. Clinical guideline. London: NICE; 2016. https://www.nice.org.uk/guidance/cg72. Accessed 28 Mar 2016
Sterne JAC, Higgins JPT, Reeves BC, on behalf of the development group for ACROBAT-NRSI. A Cochrane risk of bias assessment tool: for non-randomized studies of interventions (ACROBAT-NRSI) version 1.0.0; 2014. http://methods.cochrane.org/news/risk-bias-assessment-tool-non-randomised-studies-interventions. Accessed 18 December 2015.
Review Manager (RevMan) [Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2014.
GRADEpro GDT. GRADEpro Guideline Development Tool [Software]. (Developed by Evidence Prime, Inc.): McMaster University; 2015. http://www.gradepro.org. Accessed 3 Feb 2016.
Schünemann H, Brożek J, Guyatt GH, Oxman AD, editors. GRADE handbook for grading the quality of evidence and strength of recommendation using the GRADE approach [Updated October 2013]. The GRADE Working Group 2013. http://gdt.guidelinedevelopment.org/central_prod/_design/client/handbook/handbook.html. Accessed 18 Dec 2015.
Suwan P, Akaramethathip D, Noipayak P. Association between allergic sensitization and attention deficit hyperactivity disorder (ADHD). Asian Pac J Allergy Immunol. 2011;29(1):57–65. PubMed
Mill J, Curran S, Richards S, Taylor E, Asherson P. Polymorphisms in the dopamine D5 receptor (DRD5) gene and ADHD. Am J Med Genet B Neuropsychiatr Genet. 2004;125(1):38–42. CrossRef
Ostadali MR, Ahangari G, Eslami MB, Razavi A, Zarrindast MR, Ahmadkhaniha HR, Boulhari J. The detection of dopamine gene receptors (DRD1-DRD5) expression on human peripheral blood lymphocytes by real time PCR. Iran J of Allergy Asthma Immunol. 2004;3(4):169–74.
Nakagome K, Imamura M, Okada H, Kawahata K, Inoue T, Hashimoto K, Harada H, Higashi T, Takagi R, Nakano K, et al. Dopamine D1-like receptor antagonist attenuates Th17-mediated immune response and ovalbumin antigen-induced neutrophilic airway inflammation. J Immunol. 2011;186(10):5975–82. CrossRefPubMed
Morar N, Willis-Owen SA, Moffatt MF, Cookson WO. The genetics of atopic dermatitis. J Allergy Clin Immunol. 2006;118(3):559. CrossRef
- Allergic diseases in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis
Linda B. Mlunde
Rachel M. Amiya
- BioMed Central
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