Mahjani Behrang, Koskela Lotta Renström, Mahjani Christina Gustavsson, Janecka Magdalena, Batuure Anita, Hultman Christina M, Reichenberg Abraham, Buxbaum Joseph D, Akre Olof, Grice Dorothy E
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
Eur Child Adolesc Psychiatry. 2022 Apr;31(4):663-670. doi: 10.1007/s00787-021-01736-3. Epub 2021 Feb 26.
Lower urinary tract symptoms (LUTS), e.g., urinary frequency, pressure, urgency, and overactive bladder syndrome, are commonly reported in children with attention-deficit/hyperactivity disorder (ADHD). Understanding the co-occurrence of these conditions has implications regarding clinical approaches, treatments, and improved quality of life. We conducted a systematic review and meta-analysis to examine the relationships between LUTS and ADHD in children. We searched for articles published between January 1990 and July 2019, in PubMed, CENTRAL, and PsycNet. Two authors independently screened all articles and extracted data. We performed random-effect meta-analyses for ADHD with pooled outcomes for LUTS. We identified 119 relevant articles in the literature and 18 articles fulfilled the inclusion criteria for the systematic review, of which, 5 articles had sufficient data for meta-analysis. Examining ADHD among individuals with LUTS, the odds ratio was 2.99 (95% CI 1.13, 7.88, p < 0.001), compared to controls. In multiple studies, the mean overall score for LUTS, using a standardized measure, was significantly higher in patients with ADHD in comparison to controls, and the severity of ADHD was positively associated with the severity of LUTS. Younger age in children was correlated with a higher LUTS score. Different subtypes of urinary incontinence demonstrated differences in behavioral problems and psychiatric comorbidity. Sex differences in LUTS were not consistent across articles. Our results indicate clinically significant associations between ADHD and LUTS in children. Because LUTS and ADHD are common disorders in children, clinicians should be aware of these associations as they inform optimal assessment and treatment strategies.
下尿路症状（LUTS），如尿频、尿急、急迫性尿失禁和膀胱过度活动症，在注意力缺陷多动障碍（ADHD）儿童中很常见。了解这些病症的共现情况对临床治疗方法、治疗以及提高生活质量具有重要意义。我们进行了一项系统综述和荟萃分析，以研究儿童LUTS与ADHD之间的关系。我们在PubMed、CENTRAL和PsycNet中搜索了1990年1月至2019年7月发表的文章。两位作者独立筛选了所有文章并提取数据。我们对ADHD进行了随机效应荟萃分析，并汇总了LUTS的结果。我们在文献中确定了119篇相关文章，其中18篇符合系统综述的纳入标准，其中5篇有足够的数据进行荟萃分析。与对照组相比，在患有LUTS的个体中检查ADHD，优势比为2.99（95%CI 1.13, 7.88，p<0.001）。在多项研究中，使用标准化测量方法，ADHD患者的LUTS平均总分显著高于对照组，并且ADHD的严重程度与LUTS的严重程度呈正相关。儿童年龄越小，LUTS评分越高。不同类型的尿失禁在行为问题和精神疾病共病方面存在差异。各文章中LUTS的性别差异并不一致。我们的结果表明儿童ADHD与LUTS之间存在临床上的显著关联。由于LUTS和ADHD是儿童常见的疾病，临床医生应了解这些关联，因为它们有助于制定最佳的评估和治疗策略。
