High Risk for Attention-Deficit Hyperactive Disorder in Children with Strabismus: A Nationwide Cohort Study from the National Health Insurance Research Database
Strabismus is associated with amblyopia and a lower quality of life. Attention-deficit hyperactivity disorder (ADHD) is common among children and adolescents, and influences their academic, vocational, and social life. Previous studies have suggested an association between strabismus and ADHD. Using...
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MDPI AG
2021-10-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/11/11/1139 |
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| author | Chia-Ying Tsai Chien-Chia Su Yao-Lin Liu I-Ju Tsai Tzu-Hsun Tsai |
| author_facet | Chia-Ying Tsai Chien-Chia Su Yao-Lin Liu I-Ju Tsai Tzu-Hsun Tsai |
| author_sort | Chia-Ying Tsai |
| collection | DOAJ |
| description | Strabismus is associated with amblyopia and a lower quality of life. Attention-deficit hyperactivity disorder (ADHD) is common among children and adolescents, and influences their academic, vocational, and social life. Previous studies have suggested an association between strabismus and ADHD. Using data from the Taiwan National Health Insurance Research Database between 2000 and 2010, we performed a large-scale cohort study comparing the incidence, risk factors, and severity of ADHD in children with and without strabismus. A total of 2049 patients <18 years old with newly diagnosed strabismus (esotropia: 404; exotropia: 1645) were identified, and 8196 age- and sex-matched controls without strabismus were also included. After an average of 6.5 ± 2.9 years of follow-up, the incidence of ADHD per 1000 person-years was 5.39 in the strabismus group (esotropia: 9.93; exotropia: 4.11) and 3.23 in the control group. The cumulative incidence of ADHD was significantly greater in the esotropia (hazard ratio [HR]: 2.04; 95% confidence interval [CI]:1.36–3.06; <i>p</i> = 0.0007) and exotropia groups (HR: 1.44; 95% CI: 1.03–2.03; <i>p</i> = 0.038) than in the controls. Patients with strabismus had more comorbidities than those without (<i>p</i> < 0.05). In summary, this large-scale study found a higher cumulative incidence of ADHD in patients with strabismus, especially in those with esotropia. |
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| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-10T05:20:47Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-7e6d07a7ffa347f5a01a1fa906347f632023-11-23T00:03:23ZengMDPI AGLife2075-17292021-10-011111113910.3390/life11111139High Risk for Attention-Deficit Hyperactive Disorder in Children with Strabismus: A Nationwide Cohort Study from the National Health Insurance Research DatabaseChia-Ying Tsai0Chien-Chia Su1Yao-Lin Liu2I-Ju Tsai3Tzu-Hsun Tsai4Department of Ophthalmology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243, TaiwanDepartment of Ophthalmology, National Taiwan University Hospital, Taipei 10002, TaiwanDepartment of Ophthalmology, National Taiwan University Hospital, Taipei 10002, TaiwanDepartment of Ophthalmology, National Taiwan University Hospital, Taipei 10002, TaiwanDepartment of Ophthalmology, National Taiwan University Hospital, Taipei 10002, TaiwanStrabismus is associated with amblyopia and a lower quality of life. Attention-deficit hyperactivity disorder (ADHD) is common among children and adolescents, and influences their academic, vocational, and social life. Previous studies have suggested an association between strabismus and ADHD. Using data from the Taiwan National Health Insurance Research Database between 2000 and 2010, we performed a large-scale cohort study comparing the incidence, risk factors, and severity of ADHD in children with and without strabismus. A total of 2049 patients <18 years old with newly diagnosed strabismus (esotropia: 404; exotropia: 1645) were identified, and 8196 age- and sex-matched controls without strabismus were also included. After an average of 6.5 ± 2.9 years of follow-up, the incidence of ADHD per 1000 person-years was 5.39 in the strabismus group (esotropia: 9.93; exotropia: 4.11) and 3.23 in the control group. The cumulative incidence of ADHD was significantly greater in the esotropia (hazard ratio [HR]: 2.04; 95% confidence interval [CI]:1.36–3.06; <i>p</i> = 0.0007) and exotropia groups (HR: 1.44; 95% CI: 1.03–2.03; <i>p</i> = 0.038) than in the controls. Patients with strabismus had more comorbidities than those without (<i>p</i> < 0.05). In summary, this large-scale study found a higher cumulative incidence of ADHD in patients with strabismus, especially in those with esotropia.https://www.mdpi.com/2075-1729/11/11/1139strabismusADHDesotropia |
| spellingShingle | Chia-Ying Tsai Chien-Chia Su Yao-Lin Liu I-Ju Tsai Tzu-Hsun Tsai High Risk for Attention-Deficit Hyperactive Disorder in Children with Strabismus: A Nationwide Cohort Study from the National Health Insurance Research Database Life strabismus ADHD esotropia |
| title | High Risk for Attention-Deficit Hyperactive Disorder in Children with Strabismus: A Nationwide Cohort Study from the National Health Insurance Research Database |
| title_full | High Risk for Attention-Deficit Hyperactive Disorder in Children with Strabismus: A Nationwide Cohort Study from the National Health Insurance Research Database |
| title_fullStr | High Risk for Attention-Deficit Hyperactive Disorder in Children with Strabismus: A Nationwide Cohort Study from the National Health Insurance Research Database |
| title_full_unstemmed | High Risk for Attention-Deficit Hyperactive Disorder in Children with Strabismus: A Nationwide Cohort Study from the National Health Insurance Research Database |
| title_short | High Risk for Attention-Deficit Hyperactive Disorder in Children with Strabismus: A Nationwide Cohort Study from the National Health Insurance Research Database |
| title_sort | high risk for attention deficit hyperactive disorder in children with strabismus a nationwide cohort study from the national health insurance research database |
| topic | strabismus ADHD esotropia |
| url | https://www.mdpi.com/2075-1729/11/11/1139 |
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