Systematic review and meta-analysis: relationships between attention-deficit/hyperactivity disorder and urinary symptoms in children

European Child & Adolescent Psychiatry - Tập 31 - Trang 663-670 - 2021
Behrang Mahjani1,2,3,4, Lotta Renström Koskela5, Christina Gustavsson Mahjani1,2,3, Magdalena Janecka1,2, Anita Batuure1,4, Christina M. Hultman3, Abraham Reichenberg1,2, Joseph D. Buxbaum1,2,6,7,8, Olof Akre5,9, Dorothy E. Grice1,2,8,4,10
1Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
2Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA
3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
4Division of Tics, Obsessive-Compulsive Disorder (OCD) and Related Disorders, Icahn School of Medicine at Mount Sinai, New York, USA
5Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
6Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, USA
7Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, USA
8The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, USA
9Department of Pelvic Cancer, Karolinska Institutet, Stockholm, Sweden
10Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, USA

Tóm tắt

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.

Tài liệu tham khảo

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