The Impact of Preinjury and Secondary Attention-Deficit/Hyperactivity Disorder on Outcomes After Pediatric Traumatic Brain Injury,Journal of Developmental & Behavioral Pediatrics

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The Impact of Preinjury and Secondary Attention-Deficit/Hyperactivity Disorder on Outcomes After Pediatric Traumatic Brain Injury
Journal of Developmental & Behavioral Pediatrics ( IF 1.8 ) Pub Date : 2022-08-01 , DOI: 10.1097/dbp.0000000000001067
Megan E Narad _{1,

2} , Eloise E Kaizar ₃ , Nanhua Zhang ₄ , H Gerry Taylor _{5,

6} , Keith Owen Yeates _{7,

8,

9} , Brad G Kurowski _{10,

11} , Shari L Wade _{2,

9}

Affiliation

Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Department of Statistics, The Ohio State University, Columbus, OH.
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine.
Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH.
Department of Pediatrics, the Ohio State University, Columbus, OH.
Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Division of Physical Medicine & Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; and.
Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH.

Objective:

The objective of this study was to examine the impact of preinjury attention-deficit/hyperactivity disorder (PADHD) and secondary ADHD (SADHD) on outcomes after pediatric traumatic brain injury (TBI).

Methods:

Two hundred eighty-four individuals aged 11 to 18 years hospitalized overnight for a moderate-to-severe TBI were included in this study. Parents completed measures of child behavior and functioning and their own functioning. Linear models examined the effect of ADHD status (PADHD vs SADHD vs no ADHD) on the child's executive functioning (EF), social competence, and functional impairment, and parental depression and distress.

Results:

ADHD status had a significant effect on EF [F(2,269] = 9.19, p = 0.0001), social competence (F[2,263] = 32.28, p < 0.0001), functional impairment (F[2,269] = 16.82, p < 0.0001), parental depression (F[2,263] = 5.53, p = 0.005), and parental distress (F[2,259] = 3.57, p = 0.03). PADHD and SADHD groups had greater EF deficits, poorer social competence, and greater functional impairment than the no ADHD group. The SADHD group had greater levels of parental depression than the no ADHD and PADHD groups, and the SADHD group had higher parental distress than the no ADHD group.

Conclusion:

The results highlight the importance of early identification and management of ADHD symptoms after injury to mitigate downstream functional problems. Supporting parents managing new-onset ADHD symptoms may also be important.

中文翻译：

损伤前和继发性注意力缺陷/多动障碍对小儿创伤性脑损伤后结果的影响

客观的：

本研究的目的是探讨损伤前注意力缺陷/多动障碍 (PADHD) 和继发性注意力缺陷多动症 (SADHD) 对儿童创伤性脑损伤 (TBI) 后结局的影响。

方法：

这项研究纳入了 284 名年龄在 11 至 18 岁之间、因中度至重度 TBI 住院过夜的人。父母完成了儿童行为和功能以及他们自身功能的测量。线性模型检查了 ADHD 状态（PADHD 与 SADHD 与无 ADHD）对儿童执行功能（EF）、社交能力、功能障碍以及父母抑郁和痛苦的影响。

结果：

ADHD 状态对 EF [F(2,269] = 9.19， p = 0.0001)、社交能力 (F[2,263] = 32.28，p < 0.0001)、功能障碍 (F[2,269] = 16.82，p < 0.0001)有显着影响、父母抑郁（F[2,263] = 5.53，p = 0.005）和父母痛苦（F[2,259] = 3.57，p = 0.03）。与无 ADHD 组相比，PADHD 和 SADHD 组的 EF 缺陷更大，社交能力更差，功能障碍更严重。SADHD 组的父母抑郁程度高于无 ADHD 和 PADHD 组，并且 SADHD 组的父母痛苦程度高于无 ADHD 组。