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Objective: Unintentional injuries are the leading cause of morbidity and mortality in children and adolescents. Unintentional injuries are common in children diagnosed with attention-deficit/hyperactivity disorder (ADHD). This study aims to explore frequency and risk factors for serious unintentional injuries in children and adolescents diagnosed with ADHD.
Method: The present study consists of 1430 children and adolescents between the ages of 6-18 that were referred to Sakarya University Research and Training Hospital, and Izmit Pediatrics Hospital Child and Adolescent Psychiatry Department outpatient clinics and diagnosed to have ADHD for the first time. Children who were diagnosed with mental retardation, pervasive developmental disorders, psychosis, bipolar disorder, and drug abuse or drug addiction were excluded from the study. Information on sociodemografic characteristics, developmental steps, chronic physical illness, comorbid mental disorders, scores of Turgay DSM-IV based Child and Adolescent Behavior Disorders Screening and Rating Scale (parents form) at the time of diagnosis were assessed retrospectively. The study group includes 187 children and adolescents with serious unintentional injury history, and the control group consisted of 1247 children and adolescents without serious unintentional injury.
Results: The study group had higher rates of at least one comorbid mental disorder (p<0.001), conduct disorder (p<0.001), and oppositional defiant disorder diagnosis (p<0.001) than the control group. There were no significant differences between the groups in terms of other comorbid mental disorders. The group with an unintentional injury had all higher scores of Turgay DSM-IV based Child and Adolescent Behavior Disorders Screening and Rating Scale subscale than the group without unintentional injury: inattention (p=0.007), hyperactivity/impulsivity (p<0.001), opposition-defiance (p<0.001), and conduct disorder (p<0.001). Males had more unintentional injuries than the females (p<0.001). The mean age at the time of diagnosis was higher in the study group than the control group (p=0.002). The maternal education was lower in the study group (p=0,042). There were no significant differences between the groups in term of marital status of parents, paternal education, developmental steps, and chronic physical illness.
Conclusion: Comorbid conduct disorder, comorbid oppositional defiant disorder, and symptom severity of ADHD are related to serious unintentional injuries in children and adolescents with ADHD. The results of the present study underline the importance of early diagnosis, intervention, and treatment of comorbid mental disorders in the prevention of unintentional injuries in ADHD. Injury prevention strategies should be planned in the treatment of children and adolescents diagnosed with ADHD.