Pain-Associated Diagnoses in Childhood Before the Diagnosis of Attention-Deficit/Hyperactivity Disorder: A Population-Based Study

<b>Background:</b> Pediatric pain significantly affects children’s lives, leading to school absenteeism, impaired social interactions, and psychological distress. The perception of sensory signals as pain is influenced by the brain’s noradrenergic system, and recent evidence suggests tha...

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Main Authors: Eugene Merzon, Eli Magen, Yaniv Levy, Shai Ashkenazi, Iris Manor, Abraham Weizman, Beth Krone, Stephen V. Faraone, Ilan Green, Avivit Golan-Cohen, Shlomo Vinker, Ariel Israel
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/11/11/1388
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author Eugene Merzon
Eli Magen
Yaniv Levy
Shai Ashkenazi
Iris Manor
Abraham Weizman
Beth Krone
Stephen V. Faraone
Ilan Green
Avivit Golan-Cohen
Shlomo Vinker
Ariel Israel
author_facet Eugene Merzon
Eli Magen
Yaniv Levy
Shai Ashkenazi
Iris Manor
Abraham Weizman
Beth Krone
Stephen V. Faraone
Ilan Green
Avivit Golan-Cohen
Shlomo Vinker
Ariel Israel
author_sort Eugene Merzon
collection DOAJ
description <b>Background:</b> Pediatric pain significantly affects children’s lives, leading to school absenteeism, impaired social interactions, and psychological distress. The perception of sensory signals as pain is influenced by the brain’s noradrenergic system, and recent evidence suggests that chronic pain may impact cognitive functioning and emotional regulation. Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with alterations in the dopaminergic/noradrenergic systems, which could affect pain perception. Pain-associated conditions and frequent analgesic use in childhood may be linked to ADHD development and could serve as early indicators, yet data on this potential association remain limited. <b>Study Aim:</b> This population-based case-control study in Israel aimed to assess the prevalence of pain-related diagnoses prior to ADHD diagnosis in children aged 5 to 18. The study included children registered with Leumit Health Services (LHS) between 1 January 2006, and 30 June 2021. Children diagnosed with ADHD were compared to matched controls, selected based on age, gender, socioeconomic status, and other sociodemographic factors, who were never diagnosed with ADHD during the study period. <b>Results</b>: Children with ADHD (<i>N</i> = 18,756) and controls (<i>N</i> = 37,512) were precisely matched for sociodemographic characteristics. Individuals with ADHD exhibited significantly higher frequencies of diverse pain conditions, including those associated with illness [headache, earaches, and throat pain (odds ratios [OR] = 1.156 [95%CI 1.085, 1.232], 1.295 [95%CI 1.217, 1.377], and 1.080 [95%CI 1.019, 1.145], respectively; <i>p</i> < 0.01)] and injury [sprains and strains (OR = 1.233 [95% CI 1.104,1.376)]. Analgesics were more frequently purchased by individuals with ADHD, particularly paracetamol (OR = 1.194 [95%CI 1.152, 1.237], <i>p</i> < 0.001) and ibuprofen (OR = 1.366 [95%CI 1.318, 1.416], <i>p</i> = 0.001). <b>Conclusions:</b> This study highlights a potential connection between ADHD and pediatric pain. The elevated rates of pain diagnoses and analgesic usage among children with ADHD underscore the need for further research.
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spelling doaj-art-e3f33821ed5841cea016de8737cb0d0a2024-11-26T17:57:42ZengMDPI AGChildren2227-90672024-11-011111138810.3390/children11111388Pain-Associated Diagnoses in Childhood Before the Diagnosis of Attention-Deficit/Hyperactivity Disorder: A Population-Based StudyEugene Merzon0Eli Magen1Yaniv Levy2Shai Ashkenazi3Iris Manor4Abraham Weizman5Beth Krone6Stephen V. Faraone7Ilan Green8Avivit Golan-Cohen9Shlomo Vinker10Ariel Israel11Adelson School of Medicine, Ariel University, Ariel 4070000, IsraelLeumit Health Services, Tel-Aviv 6473817, IsraelLeumit Health Services, Tel-Aviv 6473817, IsraelAdelson School of Medicine, Ariel University, Ariel 4070000, IsraelADHD Unit, Geha Mental Health Center, Petah Tikva 491000, IsraelADHD Unit, Geha Mental Health Center, Petah Tikva 491000, IsraelIcahn School of Medicine at Mount Sinai, New York, NY 10029, USADepartments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY 13210, USALeumit Health Services, Tel-Aviv 6473817, IsraelLeumit Health Services, Tel-Aviv 6473817, IsraelLeumit Health Services, Tel-Aviv 6473817, IsraelLeumit Health Services, Tel-Aviv 6473817, Israel<b>Background:</b> Pediatric pain significantly affects children’s lives, leading to school absenteeism, impaired social interactions, and psychological distress. The perception of sensory signals as pain is influenced by the brain’s noradrenergic system, and recent evidence suggests that chronic pain may impact cognitive functioning and emotional regulation. Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with alterations in the dopaminergic/noradrenergic systems, which could affect pain perception. Pain-associated conditions and frequent analgesic use in childhood may be linked to ADHD development and could serve as early indicators, yet data on this potential association remain limited. <b>Study Aim:</b> This population-based case-control study in Israel aimed to assess the prevalence of pain-related diagnoses prior to ADHD diagnosis in children aged 5 to 18. The study included children registered with Leumit Health Services (LHS) between 1 January 2006, and 30 June 2021. Children diagnosed with ADHD were compared to matched controls, selected based on age, gender, socioeconomic status, and other sociodemographic factors, who were never diagnosed with ADHD during the study period. <b>Results</b>: Children with ADHD (<i>N</i> = 18,756) and controls (<i>N</i> = 37,512) were precisely matched for sociodemographic characteristics. Individuals with ADHD exhibited significantly higher frequencies of diverse pain conditions, including those associated with illness [headache, earaches, and throat pain (odds ratios [OR] = 1.156 [95%CI 1.085, 1.232], 1.295 [95%CI 1.217, 1.377], and 1.080 [95%CI 1.019, 1.145], respectively; <i>p</i> < 0.01)] and injury [sprains and strains (OR = 1.233 [95% CI 1.104,1.376)]. Analgesics were more frequently purchased by individuals with ADHD, particularly paracetamol (OR = 1.194 [95%CI 1.152, 1.237], <i>p</i> < 0.001) and ibuprofen (OR = 1.366 [95%CI 1.318, 1.416], <i>p</i> = 0.001). <b>Conclusions:</b> This study highlights a potential connection between ADHD and pediatric pain. The elevated rates of pain diagnoses and analgesic usage among children with ADHD underscore the need for further research.https://www.mdpi.com/2227-9067/11/11/1388pediatric pain-associated diagnosesADHDinflammation
spellingShingle Eugene Merzon
Eli Magen
Yaniv Levy
Shai Ashkenazi
Iris Manor
Abraham Weizman
Beth Krone
Stephen V. Faraone
Ilan Green
Avivit Golan-Cohen
Shlomo Vinker
Ariel Israel
Pain-Associated Diagnoses in Childhood Before the Diagnosis of Attention-Deficit/Hyperactivity Disorder: A Population-Based Study
Children
pediatric pain-associated diagnoses
ADHD
inflammation
title Pain-Associated Diagnoses in Childhood Before the Diagnosis of Attention-Deficit/Hyperactivity Disorder: A Population-Based Study
title_full Pain-Associated Diagnoses in Childhood Before the Diagnosis of Attention-Deficit/Hyperactivity Disorder: A Population-Based Study
title_fullStr Pain-Associated Diagnoses in Childhood Before the Diagnosis of Attention-Deficit/Hyperactivity Disorder: A Population-Based Study
title_full_unstemmed Pain-Associated Diagnoses in Childhood Before the Diagnosis of Attention-Deficit/Hyperactivity Disorder: A Population-Based Study
title_short Pain-Associated Diagnoses in Childhood Before the Diagnosis of Attention-Deficit/Hyperactivity Disorder: A Population-Based Study
title_sort pain associated diagnoses in childhood before the diagnosis of attention deficit hyperactivity disorder a population based study
topic pediatric pain-associated diagnoses
ADHD
inflammation
url https://www.mdpi.com/2227-9067/11/11/1388
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