Prevalence of ADHD Higher in Pediatric Patients With Mild Head Trauma

Pediatric patients who present to the emergency department with mild head trauma are more likely to also have attention deficit/hyperactivity disorder (ADHD).

A team, led by Resad Beyoglu, MD, Department of Emergency Medicine, Pamukkale University, Medical Faculty, identified the prevalence of ADHD in primary school children who visited the emergency department for mild head trauma and investigated the role of ADHD in mild head trauma.

Head trauma can result in temporary and permanent disabilities, as well as death.

Pediatric Patients With Head Trauma

The study included 134 pediatric patients aged 6-12 years who were admitted to the emergency department with mild head trauma and 134 participants who presented with complaints other than head trauma.

The investigators evaluated pediatric patients with suspected ADHD using the Turgay DSM-IV–Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S).

This scale allows clinicians to refer some patients to the child and adolescent psychiatry department (CAPD) for further evaluation. At CAPD outpatient clinics, patients who are referred from the emergency department were examined in detail using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, for possible diagnosis of ADHD.

Following an evaluation of sociodemographic characteristics and ADHD test scores, clinicians either established an ADHD diagnosis or ruled it out.

A Clear Difference in Data

Overall, 30.60% (n = 41) of pediatric patients who presented to the emergency department with mild head trauma were diagnosed with ADHD, compared to 8.96% (n = 12) of the control group (P = 0.0001).

After correcting for sex, 70.7% (n = 29) of the cases were male and 29.3% (n = 12) of cases were female (P = 0.000).

Using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and grouping patients diagnosed with ADHD according to age, the investigators found no statistically significant differences between groups in terms of ADHD (P = 0.097).

“The prevalence of ADHD has been found to be higher in children of primary school age who present to the ED with mild head trauma,” the authors wrote. “Hence, it can be deduced that the diagnosis of childhood ADHD increases the risk of presenting to the ED with head trauma.”

The investigators said the results should have some real world applications in the future.

“We believe that it is very important to keep the possible diagnosis of ADHD in mind and to refer that cases to the CAPD in case of high clinical suspicion, especially in primary school boys who are admitted to the ED with mild head trauma,” the authors wrote. “We believe that in this way, morbidity and mortality due to head trauma in this age group can be significantly reduced.”

The study, “Evaluation of the Relationship Between Head Trauma and Attention-Deficit/Hyperactivity Disorder in Primary School Children Admitted to the Emergency Department,” was published online in Pediatric Emergency Care.