ADHD linked to an increased risk of injury in children, study finds

Children and young people with attention deficit hyperactivity disorder (ADHD) are at an increased risk of injury, a study at the University of Nottingham has found.

The research, published in the journal Child: Care, Health & Development, shows that children with the developmental disorder are more likely to suffer a broken bone, sustain a burn or become the victim of an accidental poisoning.

The researchers say the results support the need for paediatricians and healthcare professionals to provide injury advice to the children and their families at the time of diagnosis and at regular reviews with paediatricians, GPs, nurses and pharmacists.

The research was carried out by Dr. Vibhore Prasad as part of his Ph.D. at Nottingham in collaboration with Professor Denise Kendrick in the University's Division of Primary Care and was supported by the National Institute of Health Research. Collaborators also included Dr. Joe West from the Division of Public Health and Epidemiology and Professor Kapil Sayal from the Institute of Mental Health.

Dr. Prasad, who is now NIHR Academic Clinical Lecturer in General Practice at King's College London, also works as a GP in Nottingham.

He said: "It may come as no surprise that children and young people with ADHD, who are more impulsive and less attentive than children without the disorder, are at an increased risk of injuries. However, these are the most detailed estimates to date for the risk of fractures, burns and poisonings, which are common types of injury."

"The results are significant because injuries are a leading cause of ill-health and deaths in children. So educating parents and carers of children with ADHD about the risks and what they can do to prevent injury could prevent a major cause of illness or even deaths."

Common injuries

The study looked at medical records of children and young people aged between three and 17 years old from the Clinical Practice Research Datalink, a primary care database containing the records of around 12 million people from 625 GP practices and representing around eight per cent of the population of the UK. The findings were based on around half of the patients from England who also had linked hospital medical records.

The research focused on the three common forms of injury in children – fractures, burns and poisonings – after diagnosis of ADHD and results showed a significant increase in the risk of injury.

Children and young people with ADHD were four times more likely to be accidentally poisoned, twice as likely to sustain a burn and had a 25 per cent increased risk of breaking a bone.

Children and young people with ADHD regularly see paediatricians, GPs and pharmacists but guidance from organisations such as the National Institute for Health and Care Excellence (NICE) and the American Academy of Pediatrics does not currently recommend counselling parents and carers on the risk of injury.

The researchers say this study shows that more should be done at diagnosis, medication reviews and follow-up visits to educate families on age-appropriate injury prevention.