Long-term bidirectional association between asthma and attention deficit hyperactivity disorder: A big data cohort study

Hye Jin Park; Young Hyeon Kim; Da Ye Na; Seong Won Jeong; Min Gyu Lee; Jong-Hwan Lee; Yun Na Yang; Min Gu Kang; Sang Woo Yeom; Jong Seung Kim

doi:10.3389/fpsyt.2022.1044742

Long-term bidirectional association between asthma and attention deficit hyperactivity disorder: A big data cohort study

Front Psychiatry. 2023 Jan 19:13:1044742. doi: 10.3389/fpsyt.2022.1044742. eCollection 2022.

Authors

Hye Jin Park¹, Young Hyeon Kim¹, Da Ye Na¹, Seong Won Jeong¹, Min Gyu Lee¹, Jong-Hwan Lee², Yun Na Yang², Min Gu Kang¹, Sang Woo Yeom¹, Jong Seung Kim^{1

2

3}

Affiliations

¹ Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
² Department of Otorhinolaryngology, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
³ Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.

Abstract

Background: Previous studies have argued that attention deficit hyperactivity disorder (ADHD) is associated with asthma. However, reliable evidence to verify this association has not yet been reported.

Objectives: To investigate the bidirectional association between asthma and ADHD through a 12-year big data cohort study.

Methods: The independent variable group was extracted from 3.5 million individuals randomly sampled by the National Health Insurance Service (NHIS). In Study 1, the incidence of ADHD according to asthma was evaluated, while in Study 2, the incidence of asthma according to ADHD was analyzed. Propensity score (PS) matching with several variables was used to obtain a control group.

Measurements and main results: In Study 1, the asthma group included 131,937 individuals and the non-asthma group included 131,937 individuals. The adjusted hazard ratio (aHR) for ADHD in the asthma group was 1.17 [95% confidence interval (CI): 1.11-1.23]. In subgroup analysis, the aHRs for ADHD of individuals in the subgroups male sex, 0-5 years old, 6-10 years old, atopic dermatitis, allergic rhinitis, Charlson comorbidity index (CCI) 1, and CCI > 2 were significant (aHR: 2.83, 1.70, 1.79, 1.09, 1.15, 1.06, and 1.49, respectively). In Study 2, ADHD was found to significantly affect asthma in all age groups (aHRs of the subgroups 0∼60 and 0∼17 years old were 1.10 and 1.09, respectively). In the 0∼17 years old subgroup, the association of ADHD with asthma was greater with younger age (aHRs of the subgroups 0∼5 and 6∼10 years old were 2.53 and 1.54, respectively).

Conclusion: From long-term follow-up, the incidence of ADHD was 1.17 times higher in the asthma group than in the control group. The incidence of asthma was 1.10 times higher in the ADHD group than in the control group. Asthma and ADHD have a bidirectional relationship, and childhood asthma and ADHD should be rigorously managed.

Keywords: ADHD; National Health Insurance Service (NHIS); asthma; cohort study; psychiatry.

Grants and funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2021R1G1A1094681) and by a grant from the Korean Health Technology R&D Project of the Korean Health Industry Development Institute (KHIDI) funded by the Ministry of Health and Welfare, South Korea (No. HI22C1124). This study was supported by a fund from the Biomedical Research Institute at Jeonbuk National University Hospital.