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      Risk of poisoning in children and adolescents with ADHD: a systematic review and meta-analysis

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          Abstract

          Poisoning, a subtype of physical injury, is an important hazard in children and youth. Individuals with ADHD may be at higher risk of poisoning. Here, we conducted a systematic review and meta-analysis to quantify this risk. Furthermore, since physical injuries, likely share causal mechanisms with those of poisoning, we compared the relative risk of poisoning and injuries pooling studies reporting both. As per our pre-registered protocol (PROSPERO ID CRD42017079911), we searched 114 databases through November 2017. From a pool of 826 potentially relevant references, screened independently by two researchers, nine studies (84,756 individuals with and 1,398,946 without the disorder) were retained. We pooled hazard and odds ratios using Robust Variance Estimation, a meta-analytic method aimed to deal with non-independence of outcomes. We found that ADHD is associated with a significantly higher risk of poisoning (Relative Risk = 3.14, 95% Confidence Interval = 2.23 to 4.42). Results also indicated that the relative risk of poisoning is significantly higher than that of physical injuries when comparing individuals with and without ADHD (Beta coefficient = 0.686, 95% Confidence Interval = 0.166 to 1.206). These findings should inform clinical guidelines and public health programs aimed to reduce physical risks in children/adolescents with ADHD.

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          Most cited references45

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          Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents.

          The literature on the prevalence of mental disorders affecting children and adolescents has expanded significantly over the last three decades around the world. Despite the field having matured significantly, there has been no meta-analysis to calculate a worldwide-pooled prevalence and to empirically assess the sources of heterogeneity of estimates.
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            ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis.

            Previous studies have identified significant variability in attention-deficit / hyperactivity disorder (ADHD) prevalence estimates worldwide, largely explained by methodological procedures. However, increasing rates of ADHD diagnosis and treatment throughout the past few decades have fuelled concerns about whether the true prevalence of the disorder has increased over time. We updated the two most comprehensive systematic reviews on ADHD prevalence available in the literature. Meta-regression analyses were conducted to test the effect of year of study in the context of both methodological variables that determined variability in ADHD prevalence (diagnostic criteria, impairment criterion and source of information), and the geographical location of studies. We identified 154 original studies and included 135 in the multivariate analysis. Methodological procedures investigated were significantly associated with heterogeneity of studies. Geographical location and year of study were not associated with variability in ADHD prevalence estimates. Confirming previous findings, variability in ADHD prevalence estimates is mostly explained by methodological characteristics of the studies. In the past three decades, there has been no evidence to suggest an increase in the number of children in the community who meet criteria for ADHD when standardized diagnostic procedures are followed.
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              Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study.

              Attention deficit hyperactivity disorder (ADHD) is a common mental disorder associated with factors that are likely to increase mortality, such as oppositional defiant disorder or conduct disorder, criminality, accidents, and substance misuse. However, whether ADHD itself is associated with increased mortality remains unknown. We aimed to assess ADHD-related mortality in a large cohort of Danish individuals.
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                Author and article information

                Contributors
                garrondo@yahoo.es
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                15 May 2018
                15 May 2018
                2018
                : 8
                : 7584
                Affiliations
                [1 ]ISNI 0000 0004 0501 3644, GRID grid.419060.a, Servicio de Urgencias Extrahospitalarias, , Servicio Navarro de Salud-Osasunbidea, ; Pamplona, Spain
                [2 ]ISNI 0000 0004 1936 9297, GRID grid.5491.9, Center for Innovation in Mental Health, , University of Southampton, Academic Unit of Psychology, ; Southampton, UK
                [3 ]ISNI 0000 0004 1936 9297, GRID grid.5491.9, Faculty of Medicine, Clinical and Experimental Sciences (CNS and Psychiatry), , University of Southampton, ; Southampton, UK
                [4 ]ISNI 0000 0001 2109 4251, GRID grid.240324.3, Department of Child and Adolescent Psychiatry, , NYU Langone Medical Center, ; New York, NY USA
                [5 ]ISNI 0000 0004 0491 7174, GRID grid.451387.c, Solent NHS Trust, ; Southampton, UK
                [6 ]ISNI 0000 0004 1936 8868, GRID grid.4563.4, Division of Psychiatry and Applied Psychology, , School of Medicine, University of Nottingham, ; Nottingham, UK
                [7 ]ISNI 0000000419370271, GRID grid.5924.a, Facultad de Educación y Psicología, , Universidad de Navarra, ; Pamplona, Spain
                [8 ]ISNI 0000 0001 2191 685X, GRID grid.411730.0, Unidad de Psiquiatría Infantil y Adolescente, Departamento de Psiquiatría y Psicología Médica, , Clínica Universidad de Navarra, ; Pamplona y Madrid, Spain
                [9 ]ISNI 0000000419370271, GRID grid.5924.a, Instituto Cultura y Sociedad (ICS), Grupo Mente-Cerebro, , Universidad de Navarra, ; Pamplona, Spain
                Author information
                http://orcid.org/0000-0003-3085-8959
                Article
                25893
                10.1038/s41598-018-25893-9
                5953942
                29765117
                1bffaf9f-2ab1-43e4-b0f7-6384b937e673
                © The Author(s) 2018

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 17 January 2018
                : 1 May 2018
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