ArticleEuropean journal of pediatrics2023
Increased fracture risk among children diagnosed with attention- deficit/hyperactivity disorder: a large matched cohort study.
Article in European journal of pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 14 citations in OpenAlex.
- Stimulant Medications and Bone Health.Current osteoporosis reports · 2026Review
- Inattention and impulsivity in attention-deficit/hyperactivity disorder (ADHD) and pediatric extremity fractures: an association between neurobehavioral traits and trauma presentation.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- Mental Health and Mental Illness in Pediatric Orthopaedic Surgery: A Systematic Review.Journal of the Pediatric Orthopaedic Society of North America · 2025Review
- Postpartum Depression Increases the Risk of Childhood Attention Deficit Hyperactivity Disorder Diagnosis.Reproductive sciences (Thousand Oaks, Calif.) · 2025Article
- Possible association between Sever's disease and attention deficit hyperactivity disorder. a prospective observational study.Journal of orthopaedic surgery and research · 2025Observational
- Factors affecting extremity fracture risk in children with attention-deficit/hyperactivity disorder.Turkish journal of medical sciences · 2025Article
- Effects of stress on bone health in children.Frontiers in endocrinology · 2025Review
- Psychological risk factors for upper extremity fractures in preschool children: A case-control study.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2024Article
- Complex interplay of neurodevelopmental disorders (NDDs), fractures, and osteoporosis: a mendelian randomization study.BMC psychiatry · 2024Article
- The role of the psychological attributes of parents and children, and fracture history in upper extremity fractures in school-age and adolescents: A case-control study.Joint diseases and related surgery · 2024Article
- Review
- Increased risk of injury and adult attention deficit hyperactivity disorder and effects of pharmacotherapy: a nationwide longitudinal cohort study in South Korea.Frontiers in psychiatry · 2024Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
To analyse the risk of fractures among children with attention-deficit/hyperactivity disorder (ADHD) compared with matched children without ADHD; and to evaluate the impact of pharmacological treatment. This registry-based cohort study included 31,330 children diagnosed with ADHD and a comparison group of 62,660 children matched by age, sex, population sector and socioeconomic status. Demographic and clinical information was extracted from the electronic database of Meuhedet, a health maintenance organization. Fracture events between 2-18 years of age were identified by coded diagnoses. The overall fracture incidence rate was 334 per 10,000 patient-years (PY) in the ADHD group and 284 per 10,000 PY in the comparison group (p < 0.001). Among boys, the fracture incidence rates were 388 per 10,000 PY and 327 per 10,000 PY (p < 0.001), for the respective groups. Among girls, the rates were lower in both groups compared to boys, but higher in the ADHD compared to the matched group (246 vs 203 per 10,000 PY, p < 0.001). Among the children with ADHD, the hazard ratios (HR) to have a fracture were similar in boys (1.18, 95%CI 1.15-1.22, p < 0.001) and girls (1.22, 95%CI 1.16-1.28, p < 0.001). Children with ADHD were also at increased risk for two and three fractures; the hazard ratios (HRs) were 1.32 (95%CI 1.26-1.38, p < 0.001) and 1.35 (95%CI 1.24-1.46, p < 0.001), respectively. In a multivariable model of the children with ADHD, pharmacological treatment was associated with reduced fracture risk (HR 0.90, 95%CI 0.82-0.98, p < 0.001) after adjustment for sex, resident socioeconomic status and population sector. Conclusion: Children with ADHD had greater fracture risk than a matched group without ADHD. Pharmacological treatment for ADHD may decrease this risk. What is Known: • Children with attention-deficit/hyperactivity disorder (ADHD) may be more prone to injuries and fractures than children without ADHD. What is New: • Children with ADHD were 1.2 times more likely to have a fracture than children with similar characteristics, without ADHD. The increased risk for fractures was even greater for two and three fractures (hazard ratios 1.32 and 1.35, respectively). • Our study suggests a positive effect of pharmacological treatment for ADHD in reducing fracture risk.
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