Environmental and Familial Risk Factors of Children and Adolescents with Attention Deficit/Hyperactivity Disorder

Hyun-Jung Park; Joon-Ho Park; Kyeong-Sae Na; Hyo Kyung Jung; Han-Yong Jung; Shin-Gyeom Kim; Soyoung Irene Lee

doi:10.4306/jknpa.2013.52.4.243

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Park, Park, Na, Jung, Jung, Kim, and Lee: Environmental and Familial Risk Factors of Children and Adolescents with Attention Deficit/Hyperactivity Disorder

Original Article

Journal of Korean Neuropsychiatric Association

Journal of Korean Neuropsychiatric Association 2013; 52(4): 243-252.

Published online: 31 July 2013

DOI: https://doi.org/10.4306/jknpa.2013.52.4.243

Environmental and Familial Risk Factors of Children and Adolescents with Attention Deficit/Hyperactivity Disorder

Hyun-Jung Park, MD¹, Joon-Ho Park, MD², Kyeong-Sae Na, MD¹, Hyo Kyung Jung, MD³, Han-Yong Jung, MD, PhD¹, Shin-Gyeom Kim, MD¹, Soyoung Irene Lee, MD, PhD¹

¹Department of Psychiatry, College of Medicine, Soonchunhyang University, Bucheon Hospital, Bucheon, Korea.

²Department of Industrial and Advertising Psychology, Daejeon University, Daejeon, Korea.

³Nanum Psychiatric Clinic, Busan, Korea.

Address for correspondence: Soyoung Irene Lee, MD, PhD. Department of Psychiatry, College of Medicine, Soonchunhyang University, Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon 420-767, Korea. Tel: +82-32-621-5063, Fax: +82-32-621-6909, irenelee@medimail.co.kr

Received 13 May 2013 Revised 20 June 2013 Accepted 1 July 2013

Abstract

Objectives

The aim of this study was to analyze the environmental and familial variables associated with attention-deficit/hyperactivity disorder (ADHD) in children and adolescents.

Methods

Children and adolescents aged 6-18 with in attention, hyperactivity, or impulsivity who visited the Department of Psychiatry at Soonchunhyang University Bucheon Hospital from April 2006 to April 2012, were interviewed for diagnosis of ADHD. Diagnostic and Statistical Manual of Mental Disorders, 4th edition symptom criteria for ADHD were assessed using a semi-structured interview, the schedule for affective disorders and schizophrenia for school-age children present and lifetime version (K-SADS-PL). Environmental and familial variables were obtained using questionnaires for parents.

Results

In total, 262 children and adolescents with ADHD (n=139) and control subjects (n=123) were recruited. In a multivariate logistic regression model, results of this study showed that maternal psychiatric problem during pregnancy, dystoia, forceps/vacuum use during delivery, and unplanned pregnancy were risk factors for ADHD.

Conclusion

Findings of this study showed an association of some prenatal factors (such as unplanned pregnancy or maternal psychiatric problem during pregnancy) and some perinatal factors (dystocia and forceps/vacuum use during delivery) with increased risk of ADHD. The identified risk factors are environmental, and therefore potentially preventable. Conduct of further prospective studies is needed in order to clarify the potential role of these risk factors for ADHD.

Keywords: ADHD, Risk factors, Environmental, Familial

Figures and Tables

Table 1

Demographic characteristics of the subjects

All data were presented as mean (±SD) or frequency (%). ^*: F=2.02, p=0.006, p-value by student's t-test, ^†: χ²=10.45, p=0.001, p-value by chi-square test, ^‡: F=0.11, p=0.01, p-value by chi-square test. ADHD: Attention-deficit/hyperactivity disorder, SD: Standard deviation, IQ: Intelligence quotient

Table 2

Neurobiological environmental risk factors between the ADHD and control groups

Adjusted for age and sex. ^*: B=0.63, Wald=4.28, p-value=0.03, ^†: B=1.55, Wald=4.94, p-value=0.02, ^‡: B=1.36, Wald=0.48, p-value= 0.006, ^§: B=1.24, Wald=0.64, p-value=0.05. ADHD: Attention-deficit/hyperactivity disorder, CI: Confidence interval

Table 3

Psychosocial environmental risk factors between the ADHD and control groups

Adjusted for age and sex. ^*: B=0.60, Wald=0.27, p-value=0.02. ADHD: Attention-deficit/hyperactivity disorder, CI: Confidence interval

Table 4

Genetic risk factors between the ADHD and control groups

Adjusted for age and sex. ^*: B=1.52, Wald=4.24, p-value=0.03. ADHD: Attention-deficit/hyperactivity disorder, CI: Confidence interval

Table 5

Odds ratio and 95% CI of risk factors

Adjusted for age and sex. CI : Confidence interval

Notes

The authors have no financial conflicts of interest.

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