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Traumatic brain injury increases risk for ADHD in adults

Adults who sustained a traumatic brain injury were significantly more likely to screen for or be diagnosed with attention-deficit/hyperactivity disorder during their lifetime, according to study findings in the Journal of Psychiatric Research.

“Recent clinical studies implicate a relationship between [ADHD] and [traumatic brain injuries] that were experienced during childhood. This may not be surprising since some of the most persistent consequences of [traumatic brain injuries] include ADHD-like symptoms, such as impairment in memory and attention, deficits in executive skills, issues related to speech articulation and decoding prosody, negative mood, and impulsiveness,” Gabriela Ilie, PhD, of St. Michael Hospital in Toronto, and colleagues wrote.

Gabriela Ilie

To determine associations between lifetime traumatic brain injury (TBI) and ADHD, researchers evaluated rolling surveys from 3,993 adults that assessed health, mental health and substance use of adults aged 18 years or older living in Ontario from 2011 through 2012. Researchers defined TBI as head trauma resulting in loss of consciousness for at least 5 minutes or overnight hospitalization.

Among participants with a history of TBI, 6.6% (95% CI, 4.7-9.4) screened positively for ADHD and 5.9% (95% CI, 3.6-9.5) reported having been diagnosed with ADHD in their lifetime.

When adjusting for sex, age and education, adults with lifetime TBI were significantly more likely to score positively on the adult ADHD Self-Report Scale-V1.1 (OR = 2.49; 95% CI, 1.54-4.04) and to report a history of diagnosed ADHD (OR = 2.64; 95% CI, 1.4-4.98) compared with adults without lifetime TBI.

“This study provides important new information. First, the association between these two conditions occurs for adults as well as adolescents and is a matter for clinical attention. Second, the two measures of ADHD — screener-based and summary item-based — provided similar results. Third, with one exception, the TBI-ADHD association appears robust, occurring roughly similarly among all categories of sex and education,” the researchers wrote. “Future research should assess if additional harm is associated with co-occurring TBI-ADHD compared to a single condition, and whether age and sex moderate the association of the combination of TBI and ADHD with health outcomes.”

“It may be useful to assess TBI history during screening and assessment of ADHD in the adult population,” Ilie said in a press release. – by Amanda Oldt

Disclosure: Please see the full study for a list of all authors’ relevant financial disclosures.