Published 6 November 2008, doi:10.1136/bmj.a1984
Cite this as: BMJ 2008;337:a1984

Research

Early head injury and attention deficit hyperactivity disorder: retrospective cohort study

¹ Department of Pediatrics, University of Utah, Salt Lake City, UT 84158, USA, ² Grimsdyke House, Ravenscroft Park, Barnet, Hertfordshire EN5 4ND, ³ Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27699, USA

Objective To explore the hypothesis that medically attended head injury in young children may be causal in the later development of attention deficit hyperactivity disorder.

Design Retrospective cohort study.

Setting Health improvement network database (1988-2003), a longitudinal UK general practice dataset.

Participants All children registered in the database from birth until their 10th birthday.

Main outcome measures Risk of a child with a head injury before age 2 developing attention deficit hyperactivity disorder before age 10 compared with children with a burn injury before age 2 and children with neither a burn nor a head injury.

Results Of the 62 088 children who comprised the cohort, 2782 (4.5%) had a head injury and 1116 (1.8%) had a burn injury. The risk of diagnosis of attention deficit hyperactivity disorder before 10 years of age after adjustment for sex, prematurity, socioeconomic status, and practice identification number was similar in the head injury (relative risk 1.9, 95% confidence interval 1.5 to 2.5) and burn injury groups (1.7, 1.2 to 2.5) compared with all other children.

Discussion Medically attended head injury before 2 years of age does not seem to be causal in the development of attention deficit hyperactivity disorder. Medically attended injury before 2 years of age may be a marker for subsequent diagnosis of attention deficit hyperactivity disorder.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Injury and attention deficit hyperactivity disorder

Morris Zwi and Philip Clamp
BMJ 2008 337: a2244. [Extract] [Full Text]

Related external webpages:

Student BMJ: Critical appraisal

This article has been cited by other articles:

• (2008). Childhood Injury and Development of ADHD: How Are They Related?. JWatch Pediatrics 2008: 5-5 [Full text]  
• (2008). Head Injury in Young Children Likely Is a Marker, Not a Cause, for ADHD. JWatch Emergency Med. 2008: 4-4 [Full text]  
• Zwi, M., Clamp, P. (2008). Injury and attention deficit hyperactivity disorder. BMJ 337: a2244-a2244 [Full text]  

Rapid Responses:

Read all Rapid Responses

Weakness point in this study: other etiological factors were not considered

Abdulrahman A. Alsawadi
bmj.com, 25 Nov 2008 [Full text]

Online poll

Find out more >>