Lehti Venla, Chudal Roshan, Suominen Auli, Gissler Mika, Sourander Andre
Research Centre for Child Psychiatry, University of Turku, Turku, Finland.
Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland.
J Child Psychol Psychiatry. 2016 Aug;57(8):967-75. doi: 10.1111/jcpp.12570. Epub 2016 May 2.
Information about psychiatric disorders among those with immigrant parents is important for early detection and service development. The aim of this study is to examine the association between parental immigration and the diagnosis of attention-deficit hyperactivity disorder (ADHD) in offspring in Finland.
This matched case-control study was based on a national birth cohort. The sample included all singletons who were born in Finland in 1991-2005 and diagnosed with ADHD by the year 2011 (n = 10,409) and their matched controls (n = 39,124). Nationwide registers were used to identify participants and to gather information on the parents' country of birth and native language. Conditional logistic regression analyses were conducted using maternal and paternal migration status and region of birth as well as time since maternal migration as exposure factors.
The likelihood of being diagnosed with ADHD was significantly increased among children of two immigrant parents [adjusted odds ratio (aOR) 4.7, 95% CI 3.4-6.6] and children of an immigrant father (aOR 1.9, 95% CI 1.6-2.2). The likelihood of receiving an ADHD diagnosis was equal among children whose mother was a recent immigrant when she gave birth and those whose mother had stayed in Finland at least for a year before birth. The association between parental migration and ADHD diagnosis was strongest among fathers born in sub-Saharan Africa or Latin America and among mothers born in sub-Saharan Africa or North Africa and Middle East. Children, whose parents were born in countries with low Human Development Index (HDI), were more often diagnosed with ADHD.
The increased likelihood of ADHD diagnosis among children of immigrants indicates increased exposure to environmental risk factors, differences in the use of health services, or challenges in diagnosing immigrants' children.
了解有移民父母者的精神疾病信息对于早期发现和服务发展至关重要。本研究旨在探讨芬兰父母移民与后代注意力缺陷多动障碍（ADHD）诊断之间的关联。
这项匹配病例对照研究基于全国出生队列。样本包括1991年至2005年在芬兰出生且截至2011年被诊断为ADHD的所有单胎儿童（n = 10409）及其匹配对照（n = 39124）。利用全国性登记册来识别参与者并收集父母的出生国家和母语信息。以母亲和父亲的移民身份、出生地区以及母亲移民后的时间为暴露因素进行条件逻辑回归分析。
父母双方均为移民的儿童（调整优势比[aOR] 4.7，95%可信区间[CI] 3.4 - 6.6）和父亲为移民的儿童（aOR 1.9，95% CI 1.6 - 2.2）被诊断为ADHD的可能性显著增加。母亲在分娩时为新移民的儿童与母亲在分娩前至少在芬兰停留一年的儿童被诊断为ADHD的可能性相同。父母移民与ADHD诊断之间的关联在出生于撒哈拉以南非洲或拉丁美洲的父亲以及出生于撒哈拉以南非洲或北非及中东的母亲中最为明显。父母出生在人类发展指数（HDI）较低国家的儿童更常被诊断为ADHD。
移民儿童被诊断为ADHD的可能性增加表明其暴露于环境风险因素的情况增加、医疗服务使用存在差异或在诊断移民子女方面存在挑战。
