Association of atopic diseases and attention-deficit/hyperactivity disorder: A systematic review and meta-analyses
Over the last decades, the hypothesis has been raised that an atopic response could lead to the development of attention-deficit/hyperactivity disorder (ADHD). This study systematically reviews the observational cross-sectional and longitudinal studies that assessed the association between atopic disorders including asthma, atopic eczema, allergic rhinitis, and ADHD in children and adolescents. For longitudinal studies, a weighted Mantel-Haenszel odds ratio of these associations was estimated. The majority of cross-sectional and longitudinal studies reported a statistically significant positive association. The meta-analysis of longitudinal studies revealed an overall weighted odds ratio for asthma of 1.34 (95% confidence interval [CI] 1.24–1.44), 1.32 (95% CI 1.20–1.45) for atopic eczema, and 1.52 (95% CI 1.43-1.63) for allergic rhinitis. Heterogeneity of study data was low (I2: 0%, p = 0.46 and p = 0.64, respectively) for both studies examining asthma and eczema but substantial for rhinitis studies (I2: 82%, p = 0.004). This current systematic review provides strong evidence that ADHD is associated with atopic diseases and that individuals have a 30% to 50% greater chance of developing ADHD compared to controls.