Narad ME, Kennelly M, Zhang N, et al. Secondary Attention-Deficit/Hyperactivity Disorder in Children and Adolescents 5 to 10 Years After Traumatic Brain Injury. JAMA Pediatr. 2018;172(5):437–443. doi:10.1001/jamapediatrics.2017.5746
In this cohort study that included 187 children, severe traumatic brain injury and lower levels of maternal educational level were significantly associated with increased risk for secondary attention-deficit/hyperactivity disorder (SADHD). Family dysfunction was significantly associated with increased risk in patients with traumatic brain injury but not in patients with orthopedic injury.
Across the spectrum of TBI severity, the risk for SADHD was increased and most strongly associated with severe TBI. SADHD developed within the first 18 months of injury in most children with severe TBI, and researchers emphasized the importance of continued monitoring post-TBI. Additionally, the association between family dysfunction and risk for SADHD may indicate a particular need for survey of family functioning. Researchers noted that patient-reported data are susceptible to reporting bias, and that their SADHD cutoff may have excluded patients displaying ADHD-adjacent behavior, thus limiting data generalizability. For future studies, scientists suggested the inclusion of a wider range of injury severity and a more in-depth assessment of environmental and genetic factors to better understand post-injury risk for SADHD developing in adolescents and children.