The effect of attention-deficit hyperactivity disorder symptoms on fracture occurrence in patients with osteopenia and osteoporosis

Objective: Information and understanding of the relationship between attention-deficit hyperactivity disorder (ADHD) in adulthood and general medical conditions is limited. The aim of this study was to evaluate the relationship between ADHD symptoms and fractures in patients diagnosed with osteopenia/osteoporosis. Method: A total of 100 patients (96 females, 4 males; aged 45-75 years) with a T-score of ≤1 were included in the study. The ADHD symptoms of the participants were assessed using the Wender Utah Rating Scale (WURS) and the Adult ADHD Self- Report Scale (ASRS). The number of fractures, presence of systemic disease, and duration of treatment of the patients were recorded and analyzed. Results: A significant difference in the total WURS and attention/irritability subscores was observed between the groups of those with and without a history of fracture. MANCOVA used to control confounding factors of gender, age, bone mineral densitometry values, presence of systemic disease and body mass index, revealed that the WURS irritability, attention, and total scores were significantly higher in the group with a history of fractures. Conclusion: The results of this study of adults indicated that fracture occurrence was associated with attention and irritability symptoms of childhood ADHD. These findings may provide better insight and understanding of the lifelong, negative impact of ADHD on physical health.

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1. Kan SL, Yuan ZF, Chen LX, Sun JC, Ning GZ, Feng SQ. Which is best for osteoporotic vertebral compression fractures: balloon kyphoplasty, percutaneous vertebroplasty or non-surgical treatment? A study protocol for a Bayesian network metaanalysis. BMJ Open 2017; 7:e012937. [CrossRef]

2. Watts JJ, Abimanyi-Ochom J, Sanders KM. Osteoporosis costing all Australian: a new burden of disease analysis-2012 to 2022. 2013. https://healthybonesaustralia.org.au/wp-content/ uploads/2020/11/Burden-of-Disease-Analysis-2012-2022.pdf. Accessed July 17, 2020. [CrossRef]

3. Qaseem A, Forciea MA, McLean RM, Denberg TD; Clinical Guidelines Committee of the American College of Physicians. Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women: A Clinical Practice Guideline Update From the American College of Physicians. Ann Intern Med 2017; 166:818-839. [CrossRef]

4. Kanis JA, Cooper C, Rizzoli R, Reginster JY; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2019; 30:3-44. [CrossRef]

5. Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, et al; National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int 2014; 25:2359-2381. [CrossRef]

6. Barkley RA. Attention-deficit/hyperactivity Disorder, Self- Regulation, and Executive Functioning: In Vohs K, Baumeister RF, (editors). Handbook of Self-Regulation. New York: Guilford; 2011, 551-563.[CrossRef]

7. Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007; 164:942-948.

8. Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, et al. The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. Am J Psychiatry 2006; 163:716-723. [CrossRef]

9. Shaw-Zirt B, Popali-Lehane L, Chaplin W, Bergman A. Adjustment, social skills, and self-esteem in college students with symptoms of ADHD. J Atten Disord 2005; 8:109-120. [CrossRef]

10. Shilon Y, Pollak Y, Aran A, Shaked S, Gross-Tsur V. Accidental injuries are more common in children with attention deficit hyperactivity disorder compared with their non-affected siblings. Child Care Health Dev 2012; 38:366-370.[CrossRef]

11. Schwebel DC, Gaines J. Pediatric unintentional injury: Behavioral risk factors and implications for prevention. J Dev Behav Pediatr 2007; 28:245-254. [CrossRef]

12. Barkley RA. Driving impairments in teens and adults with attention-deficit/hyperactivity disorder. Psychiatr Clin North Am 2004; 27:233-260. [CrossRef]

13. Saxbe C, Barkley RA. The second attention disorder? Sluggish cognitive tempo vs. attention-deficit/hyperactivity disorder: Update for clinicians. J Psychiatr Pract 2014; 20:38-49. [CrossRef]

14. Gillberg C, Kadesjö B. Why bother about clumsiness? The implications of having developmental coordination disorder (DCD). Neural Plast 2003; 10:59-68. [CrossRef]

15. Uslu MM, Uslu R. Extremity fracture characteristics in children with impulsive/hyperactive behavior. Arch Orthop Trauma Surg 2008; 128:417-421. [CrossRef]

16. Barkley RA, Cox D. A review of driving risks and impairments associated with attention-deficit/hyperactivity disorder and the effects of stimulant medication on driving performance. J Safety Res 2007; 38:113-128. [CrossRef]

17. Pastor PN, Reuben CA. Identified attention-deficit/hyperactivity disorder and medically attended, nonfatal injuries: US school-age children, 1997-2002. Ambul Pediatr 2006; 6:38-44. [CrossRef]

18. Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): A short screening scale for use in the general population. Psychol Med 2005; 35:245-256. [CrossRef]

19. Dogan S, Oncu B, Varol-Saracoglu G, Kucukgoncu S. Validity and reliability of the Turkish version of the Adult ADHD Self- Report Scale (ASRS-v1. 1). Anatolian Journal of Psychiatry 2009; 10:77-87.

20. Ward MF, Wender PH, Reimherr FW. The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry 1993; 150:885- 890. [CrossRef]

21. Oncu B, Olmez S, Senturk V. Validity and reliability of the Turkish version of the Wender Utah Rating Scale for attentiondeficit/ hyperactivity disorder in adults. Turk Psikiyatri Derg 2005; 16:252-259. [Turkish]

22. Uslu MM, Uslu R. Extremity fracture characteristics in children with impulsive/hyperactive behavior. Arch Orthop Trauma Surg 2008; 128:417-421. [CrossRef]

23. Komurcu E, Bilgic A, Herguner S. Relationship between extremity fractures and attention-deficit/hyperactivity disorder symptomatology in adults. Int J Psychiatry Med 2014; 47:55-63.

24. Stavrinos D, Biasini FJ, Fine PR, Hodgens JB, Khatri S, Mrug S, et al. Mediating factors associated with pedestrian injury in children with attention-deficit/hyperactivity disorder. Pediatrics 2011; 128:296-302. [CrossRef]

25. Barkley RA, Murphy KR, Dupaul GI, Bush T. Driving in young adults with attention deficit hyperactivity disorder: Knowledge, performance, adverse outcomes, and the role of executive functioning. J Int Neuropsychol Soc 2002; 8:655-672. [CrossRef]

26. Garzon DL, Huang H, Todd RD. Do attention deficit/hyperactivity disorder and oppositional defiant disorder influence preschool unintentional injury risk? Arch Psychiatr Nurs 2008; 22:288-296.

27. Merrill RM, Lyon JL, Baker RK, Gren LH. Attention deficit hyperactivity disorder and increased risk of injury. Adv Med Sci 2009; 54:20-26. [CrossRef]

28. Chou IC, Lin CC, Sung FC, Kao CH. Attention-deficithyperactivity disorder increases risk of bone fracture: A population-based cohort study. Dev Med Child Neurol 2014; 56:1111-1116. [CrossRef]

29. Perry BA, Archer KR, Song Y, Ma Y, Green JK, Elefteriou F, et al. Medication therapy for attention deficit/hyperactivity disorder is associated with lower risk of fracture: a retrospective cohort study. Osteoporos Int 2016; 27:2223-2227. [CrossRef]

30. Lam LT. Distractions and the risk of car crash injury: The effect of drivers' age. J Safety Res 2002; 33:411-419. [CrossRef]

31. Bessette L, Ste-Marie LG, Jean S, Davison KS, Beaulieu M, Baranci M, Bessant J, et al. The care gap in diagnosis and treatment of women with a fragility fracture. Osteoporos Int 2008; 19:79-86.

32. Cheung AM, Detsky AS. Osteoporosis and fractures: missing the bridge? JAMA 2008; 299:1468-1470. [CrossRef]

33. Barkley RA, Murphy KR, Kwasnik D. Motor vehicle driving competencies and risks in teens and young adults with attention deficit hyperactivity disorder. Pediatrics 1996; 98:1089-1095.

34. Deffenbacher JL, Lynch RS, Filetti LB, Dahlen ER, Oetting ER. Anger, aggression, risky behavior, and crash-related outcomes in three groups of drivers. Behav Res Ther 2003; 41:333-349.[CrossRef]

35. Bell MA, Calkins SD. Attentional Control and Emotion Regulation in Early Development. In Posner MI, (editor). Cognitive Neuroscience of Attention. Second ed., New York: Guilford Press; 2012, 322-330.

36. Pessoa L, Pereira MG, Oliveira L. Attention and emotion. Scholarpedia 2010; 5:6314. [CrossRef]

37. Predine R, Chau N, Lorentz N, Predine E, Legras B, Benamgher L, et al. School-related injures: indices, causes, and consequences. Rev Epidemiol Sante Publique 2002; 50:265-276. [French]
Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi-Cover
  • ISSN: 1018-8681
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1984
  • Yayıncı: Kare Yayıncılık
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