TY - JOUR
T1 - Systematic review and meta-analysis
T2 - relationships between attention-deficit/hyperactivity disorder and urinary symptoms in children
AU - Mahjani, Behrang
AU - Koskela, Lotta Renström
AU - Mahjani, Christina Gustavsson
AU - Janecka, Magdalena
AU - Batuure, Anita
AU - Hultman, Christina M.
AU - Reichenberg, Abraham
AU - Buxbaum, Joseph D.
AU - Akre, Olof
AU - Grice, Dorothy E.
N1 - Funding Information:
DEG, MJ, JDB, BM receive support from the Beatrice and Samuel A. Seaver Foundation; additional support from the Mindworks Charitable Lead Trust (DEG); the Stanley Center for Psychiatric Research (DEG).
Publisher Copyright:
© 2021, Springer-Verlag GmbH, DE part of Springer Nature.
PY - 2022/4
Y1 - 2022/4
N2 - Lower urinary tract symptoms (LUTS), e.g., urinary frequency, pressure, urgency, and overactive bladder syndrome, are commonly reported in children with attention-deficit/hyperactivity disorder (ADHD). Understanding the co-occurrence of these conditions has implications regarding clinical approaches, treatments, and improved quality of life. We conducted a systematic review and meta-analysis to examine the relationships between LUTS and ADHD in children. We searched for articles published between January 1990 and July 2019, in PubMed, CENTRAL, and PsycNet. Two authors independently screened all articles and extracted data. We performed random-effect meta-analyses for ADHD with pooled outcomes for LUTS. We identified 119 relevant articles in the literature and 18 articles fulfilled the inclusion criteria for the systematic review, of which, 5 articles had sufficient data for meta-analysis. Examining ADHD among individuals with LUTS, the odds ratio was 2.99 (95% CI 1.13, 7.88, p < 0.001), compared to controls. In multiple studies, the mean overall score for LUTS, using a standardized measure, was significantly higher in patients with ADHD in comparison to controls, and the severity of ADHD was positively associated with the severity of LUTS. Younger age in children was correlated with a higher LUTS score. Different subtypes of urinary incontinence demonstrated differences in behavioral problems and psychiatric comorbidity. Sex differences in LUTS were not consistent across articles. Our results indicate clinically significant associations between ADHD and LUTS in children. Because LUTS and ADHD are common disorders in children, clinicians should be aware of these associations as they inform optimal assessment and treatment strategies.
AB - Lower urinary tract symptoms (LUTS), e.g., urinary frequency, pressure, urgency, and overactive bladder syndrome, are commonly reported in children with attention-deficit/hyperactivity disorder (ADHD). Understanding the co-occurrence of these conditions has implications regarding clinical approaches, treatments, and improved quality of life. We conducted a systematic review and meta-analysis to examine the relationships between LUTS and ADHD in children. We searched for articles published between January 1990 and July 2019, in PubMed, CENTRAL, and PsycNet. Two authors independently screened all articles and extracted data. We performed random-effect meta-analyses for ADHD with pooled outcomes for LUTS. We identified 119 relevant articles in the literature and 18 articles fulfilled the inclusion criteria for the systematic review, of which, 5 articles had sufficient data for meta-analysis. Examining ADHD among individuals with LUTS, the odds ratio was 2.99 (95% CI 1.13, 7.88, p < 0.001), compared to controls. In multiple studies, the mean overall score for LUTS, using a standardized measure, was significantly higher in patients with ADHD in comparison to controls, and the severity of ADHD was positively associated with the severity of LUTS. Younger age in children was correlated with a higher LUTS score. Different subtypes of urinary incontinence demonstrated differences in behavioral problems and psychiatric comorbidity. Sex differences in LUTS were not consistent across articles. Our results indicate clinically significant associations between ADHD and LUTS in children. Because LUTS and ADHD are common disorders in children, clinicians should be aware of these associations as they inform optimal assessment and treatment strategies.
KW - Attention-deficit/hyperactivity disorder
KW - Lower urinary tract symptoms
KW - Overactive bladder
UR - http://www.scopus.com/inward/record.url?scp=85101745229&partnerID=8YFLogxK
U2 - 10.1007/s00787-021-01736-3
DO - 10.1007/s00787-021-01736-3
M3 - Article
C2 - 33635440
AN - SCOPUS:85101745229
SN - 1018-8827
VL - 31
SP - 663
EP - 670
JO - European Child and Adolescent Psychiatry
JF - European Child and Adolescent Psychiatry
IS - 4
ER -