Attention Deficit Hyperactivity Disorder as a Risk Factor for Fractures

INTRODUCTION: It has been reported that attention-deficit/hyperactivity disorder (ADHD) is related to an increased risk of fracture. However, relevant data have been provided from either population with fractures or population-based cohort studies. In this study, we aimed to determine the fracture risk in children with ADHD.
METHODS: The children with ADHD between the ages of 6 and 16 who were admitted between April 2019 and July 2020 and healthy children matching in age and gender were included in this study. A semi-constructed diagnosis interview, Conners' Parent Rating Scale-Revised Short Form, and Strengths and Difficulties Questionnaire were administered to both groups.
RESULTS: Two hundred and twelve children with ADHD and 215 healthy children were included in this study. One-time fracture was found in 76 (35.8%) children in the ADHD group and 39 (18.1%) children in the healthy group (p<0.001). While there were recurrent fractures in 27 (12.7%) patients in the ADHD group, this rate was 13 (6.0%) for healthy controls (p=0.018). Also, 45 (59.2%) of the children with fractures and 57 (41.9%) of the children without fractures had comorbid diseases (p=0.016).
DISCUSSION AND CONCLUSION: ADHD poses a significant risk for fractures and is related to an increased risk of fracture. It would be advisable to screen children with bone fractures concerning ADHD and referring them to a child and adolescent psychiatrist if there is a suspicion of ADHD.