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Association of Attention deficit hyperactivity disorder and Kawasaki disease: a nationwide population-based cohort study

Published online by Cambridge University Press:  22 September 2015

H.-C. Kuo Open the ORCID record for H.-C. Kuo [Opens in a new window] ,
W.-C. Chang ,
L.-J. Wang ,
S.-C. Li  and
W.-P. Chang
H.-C. Kuo
Affiliation:
Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Taiwan College of Medicine, Chang Gung University, Kaohsiung, Taiwan
W.-C. Chang
Affiliation:
Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan
L.-J. Wang
Affiliation:
Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan
S.-C. Li
Affiliation:
Department of Pharmacy, Taipei Medical University-Wanfang Hospital, Taipei, Taiwan
W.-P. Chang*
Affiliation:
Department of Healthcare Management, YuanPei University of Medical Technology, HsinChu, Taiwan
*
*Address for correspondence: W.-P. Chang, Department of Healthcare Management, YuanPei University of Medical Technology, HsinChu, Taiwan. (Email: [email protected])
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Abstract

Aims.

The association between Kawasaki disease (KD) and Attention deficit hyperactivity disorder (ADHD) has rarely been studied. In this study, we investigated the hypothesis that KD may increase the risk of ADHD using a nationwide Taiwanese population-based claims database.

Methods.

Our study cohort consisted of patients who were diagnosed with KD between January 1997 and December 2005 (N = 651). For a comparison cohort, five age- and gender-matched control patients for every patient in the study cohort were selected using random sampling (N = 3255). The cumulative incidence of ADHD was 3.89/1000 (from 0.05 to 0.85) in this study. All subjects were tracked for 5 years from the date of cohort entry to identify whether or not they had developed ADHD. Cox proportional hazard regression analysis was performed to evaluate 5-year ADHD-free survival rates.

Results.

Of all patients, 83 (2.1%) developed ADHD during the 5-year follow-up period, of whom 21 (3.2%) had KD and 62 (1.9%) were in the comparison cohort. The patients with KD seemed to be at an increased risk of developing ADHD (crude hazard ratio (HR): 1.71; 95% confidence interval (CI) = 1.04–2.80; p < 0.05). However, after adjusting for gender, age, asthma, allergic rhinitis, atopic dermatitis and meningitis, the adjusted hazard ratios (AHR) of the ADHD in patients with KD showed no association with the controls (AHR: 1.59; 95% CI = 0.96–2.62; p = 0.07). We also investigated whether or not KD was a gender-dependent risk factor for ADHD, and found that male patients with KD did not have an increased risk of ADHD (AHR: 1.62; 95% CI = 0.96–2.74; p = 0.07) compared with the female patients.

Conclusions.

The findings of this population-based study suggest that patients with KD may not have an increased risk of ADHD and whether or not there is an association between KD and ADHD remains uncertain.

Keywords

ADHDKawasaki diseasepopulation-based study
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 25 , Issue 6 , December 2016 , pp. 573 - 580
Copyright
Copyright © Cambridge University Press 2015 

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References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association: Washington, DC.Google Scholar
Arnsten, AF, Pliszka, SR (2011). Catecholamine influences on prefrontal cortical function: relevance to treatment of attention deficit/hyperactivity disorder and related disorders. Pharmacology Biochemistry and Behavior 99, 211–216.CrossRefGoogle ScholarPubMed
Bae, YJ, Kim, MH, Lee, HY, Uh, Y, Namgoong, MK, Cha, BH, Chun, JK (2012). Elevated serum levels of IL-21 in Kawasaki disease. Allergy, Asthma and Immunology Research 4, 351–356.CrossRefGoogle ScholarPubMed
Burns, JC, Glode, MP (2004). Kawasaki syndrome. Lancet 364, 533–544.Google ScholarPubMed
Burns, JC, Shimizu, C, Shike, H, Newburger, JW, Sundel, RP, Baker, AL, Matsubara, T, Ishikawa, Y, Brophy, VA, Cheng, S, Grow, MA, Steiner, LL, Kono, N, Cantor, RM (2005). Family-based association analysis implicates IL-4 in susceptibility to Kawasaki disease. Genes and Immunity 6, 438–444.CrossRefGoogle ScholarPubMed
Buske-Kirschbaum, A, Schmitt, J, Plessow, F, Romanos, M, Weidinger, S, Roessner, V (2013). Psychoendocrine and psychoneuroimmunological mechanisms in the comorbidity of atopic eczema and attention deficit/hyperactivity disorder. Psychoneuroendocrinology 38, 12–23.CrossRefGoogle ScholarPubMed
Chen, CY, Yeh, HH, Chen, KH, Chang, IS, Wu, EC, Lin, KM (2011). Differential effects of predictors on methylphenidate initiation and discontinuation among young people with newly diagnosed attention-deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology 21, 265–273.CrossRefGoogle ScholarPubMed
Chen, MH, Su, TP, Chen, YS, Hsu, JW, Huang, KL, Chang, WH, Chen, TJ, Bai, YM (2013). Comorbidity of allergic and autoimmune diseases among patients With ADHD: a nationwide population-based study. Journal of Attention Disorders. doi: 10.1177/1087054712474686.Google Scholar
Galera, C, Cote, SM, Bouvard, MP, Pingault, JB, Melchior, M, Michel, G, Boivin, M, Tremblay, RE (2011). Early risk factors for hyperactivity-impulsivity and inattention trajectories from age 17 months to 8 years. Archives of General Psychiatry 68, 1267–1275.Google ScholarPubMed
Gau, SS, Chong, MY, Chen, TH, Cheng, AT (2005). A 3-year panel study of mental disorders among adolescents in Taiwan. American Journal of Psychiatry 162, 1344–1350.CrossRefGoogle ScholarPubMed
Hak, E, de Vries, TW, Hoekstra, PJ, Jick, SS (2013). Association of childhood attention-deficit/hyperactivity disorder with atopic diseases and skin infections? A matched case-control study using the General Practice Research Database. Annals of Allergy, Asthma and Immunology 111, 102–106 e102.Google ScholarPubMed
Hikita, T, Kaminaga, T, Wakita, S, Ogita, K, Ikemoto, H, Fujii, Y, Oba, H, Yanagawa, Y (2011). Regional cerebral blood flow abnormalities in patients with Kawasaki disease. Clinical Nuclear Medicine 36, 643–649.CrossRefGoogle ScholarPubMed
Huang, WC, Huang, LM, Chang, IS, Chang, LY, Chiang, BL, Chen, PJ, Wu, MH, Lue, HC, Lee, CY (2009). Epidemiologic features of Kawasaki disease in Taiwan, 2003–2006. Pediatrics 123, e401–e405.CrossRefGoogle ScholarPubMed
Hwang, CY, Hwang, YY, Chen, YJ, Chen, CC, Lin, MW, Chen, TJ, Lee, DD, Chang, YT, Wang, WJ, Liu, HN (2013). Atopic diathesis in patients with kawasaki disease. The Journal of Pediatrics 163, 811–815.CrossRefGoogle ScholarPubMed
Kim, BN, Lee, JS, Shin, MS, Cho, SC, Lee, DS (2002). Regional cerebral perfusion abnormalities in attention deficit/hyperactivity disorder. Statistical parametric mapping analysis. European Archives of Psychiatry and Clinical Neuroscience 252, 219–225.Google ScholarPubMed
Kuo, HC, Yang, KD, Liang, CD, Bong, CN, Yu, HR, Wang, L, Wang, CL (2007). The relationship of eosinophilia to intravenous immunoglobulin treatment failure in Kawasaki disease. Pediatric Allergy and Immunology 18, 354–359.CrossRefGoogle ScholarPubMed
Kuo, HC, Wang, CL, Liang, CD, Yu, HR, Huang, CF, Wang, L, Hwang, KP, Yang, KD (2009). Association of lower eosinophil-related T helper 2 (Th2) cytokines with coronary artery lesions in Kawasaki disease. Pediatric Allergy and Immunology 20, 266–272.CrossRefGoogle ScholarPubMed
Kuo, HC, Yang, KD, Chang, WC, Ger, LP, Hsieh, KS (2012). Kawasaki disease: an update on diagnosis and treatment. Pediatrics and Neonatology 53, 4–11.CrossRefGoogle ScholarPubMed
Kuo, HC, Chang, WC, Yang, KD, Yu, HR, Wang, CL, Ho, SC, Yang, CY (2013). Kawasaki disease and subsequent risk of allergic diseases: a population-based matched cohort study. BMC Pediatrics 13, 38.Google Scholar
Lee, CP, Huang, YH, Hsu, YW, Yang, KD, Chien, HC, Yu, HR, Yang, YL, Wang, CL, Chang, WC, Kuo, HC (2013). TARC/CCL17 gene polymorphisms and expression associated with susceptibility and coronary artery aneurysm formation in Kawasaki disease. Pediatric Research 74, 545–551.Google ScholarPubMed
Liang, CD, Kuo, HC, Yang, KD, Wang, CL, Ko, SF (2009). Coronary artery fistula associated with Kawasaki disease. American Heart Journal 157, 584–588.CrossRefGoogle ScholarPubMed
Millichap, JG (2008). Etiologic classification of attention-deficit/hyperactivity disorder. Pediatrics 121, e358–e365.CrossRefGoogle ScholarPubMed
Newburger, JW, Takahashi, M, Gerber, MA, Gewitz, MH, Tani, LY, Burns, JC, Shulman, ST, Bolger, AF, Ferrieri, P, Baltimore, RS, Wilson, WR, Baddour, LM, Levison, ME, Pallasch, TJ, Falace, DA, Taubert, KA (2004). Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 110, 2747–2771.CrossRefGoogle Scholar
Polanczyk, G, de Lima, MS, Horta, BL, Biederman, J, Rohde, LA (2007). The worldwide prevalence of ADHD: a systematic review and metaregression analysis. American Journal of Psychiatry 164, 942–948.Google ScholarPubMed
Sagiv, SK, Epstein, JN, Bellinger, DC, Korrick, SA (2013). Pre- and postnatal risk factors for ADHD in a nonclinical pediatric population. Journal of Attention Disorders 17, 47–57.CrossRefGoogle Scholar
Schmitt, J, Buske-Kirschbaum, A, Roessner, V (2010). Is atopic disease a risk factor for attention-deficit/hyperactivity disorder? A systematic review. Allergy 65, 1506–1524.CrossRefGoogle ScholarPubMed
Spencer, TJ, Biederman, J, Mick, E (2007). Attention-deficit/hyperactivity disorder: diagnosis, lifespan, comorbidities, and neurobiology. Journal of Pediatric Psychology 32, 631–642.CrossRefGoogle ScholarPubMed
Tsai, JD, Chang, SN, Mou, CH, Sung, FC, Lue, KH (2013 a). Association between atopic diseases and attention-deficit/hyperactivity disorder in childhood: a population-based case-control study. Annals of Epidemiology 23, 185–188.CrossRefGoogle ScholarPubMed
Tsai, YJ, Lin, CH, Fu, LS, Fu, YC, Lin, MC, Jan, SL (2013 b). The association between Kawasaki disease and allergic diseases, from infancy to school age. Allergy and Asthma Proceedings 34, 467–472.CrossRefGoogle ScholarPubMed
Wang, CL, Wu, YT, Liu, CA, Kuo, HC, Yang, KD (2005). Kawasaki disease: infection, immunity and genetics. The Pediatric Infectious Disease Journal 24, 998–1004.Google ScholarPubMed
Wang, Y, Wang, W, Gong, F, Fu, S, Zhang, Q, Hu, J, Qi, Y, Xie, C, Zhang, Y (2013). Evaluation of intravenous immunoglobulin resistance and coronary artery lesions in relation to Th1/Th2 cytokine profiles in patients with Kawasaki disease. Arthritis and Rheumatology 65, 805–814.CrossRefGoogle ScholarPubMed
Weng, KP, Ho, TY, Chiao, YH, Cheng, JT, Hsieh, KS, Huang, SH, Ou, SF, Liu, KH, Hsu, CJ, Lu, PJ, Hsiao, M, Ger, LP (2010). Cytokine genetic polymorphisms and susceptibility to Kawasaki disease in Taiwanese children. Circulation Journal 74, 2726–2733.Google ScholarPubMed
Yaghmaie, P, Koudelka, CW, Simpson, EL (2013). Mental health comorbidity in patients with atopic dermatitis. Journal of Allergy and Clinical Immunology 131, 428–433.Google ScholarPubMed