Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
J Child Psychol Psychiatry. 2013 Nov;54(11):1208-14. doi: 10.1111/jcpp.12087. Epub 2013 Jun 3.
Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early childhood would increase the risk of ADHD in later life.
In all, 2,294 children with asthma and 9,176 controls aged between 0 and 3 years in 2000 were included in our study. Cases of ADHD that occurred to the end of follow-up (31 December 2010) were identified.
Children with asthma had a higher incidence of developing ADHD (7% vs. 4.6%, p < .001) than control cohort during the follow-up period. After adjusting for age at enrollment, gender, level of urbanization, and comorbid allergic diseases (allergic rhinitis and atopic dermatitis), children with asthma had an elevated risk (HR: 1.31, 95% CI: 1.07-1.59) of developing ADHD compared with control group.
Our prospective study supported a temporal relationship between asthma and ADHD. Asthma in very early life increased the risk of developing ADHD during the school years. Further studies are required to investigate whether the prompt treatment of asthma and comorbid allergic diseases could prevent the development of ADHD or decrease ADHD symptoms.
先前的横断面研究表明哮喘与注意缺陷多动障碍（ADHD）之间存在关联，但尚未确定两者之间的时间关系。本研究采用全国性基于人群的前瞻性病例对照队列研究（1:4，年龄/性别匹配），假设婴儿期或幼儿期哮喘会增加日后发生 ADHD 的风险。
共纳入 2000 年 0 至 3 岁的哮喘儿童 2294 例和年龄、性别相匹配的对照儿童 9176 例。随访结束（2010 年 12 月 31 日）时，确定 ADHD 病例。
随访期间，哮喘儿童发生 ADHD 的发生率（7%比 4.6%，p<0.001）高于对照组。在校正入组时的年龄、性别、城市化水平以及合并的过敏性疾病（过敏性鼻炎和特应性皮炎）后，与对照组相比，哮喘儿童发生 ADHD 的风险升高（HR：1.31，95%CI：1.07-1.59）。
本前瞻性研究支持哮喘与 ADHD 之间存在时间关系。婴儿期哮喘会增加学龄期发生 ADHD 的风险。需要进一步研究及时治疗哮喘和合并的过敏性疾病是否可以预防 ADHD 的发生或降低 ADHD 症状的严重程度。
