Attention deficit/hyperactivity disorder in children with nasal trauma: a casecontrol study

Background: Relationship between Attention deficit/hyperactivity disorder (ADHD) and the risk of injury has been systematically evaluated and documented. Children with ADHD may be more prone to injuries, such as falls, that is a major cause of nasal trauma. To our knowledge, no studies have explored the relationship between nasal trauma and ADHD in the pediatric population. Aims: To investigate the potential association between nasal trauma and ADHD symptomatology in children 4-12 years of age and to assess the family functioning of the nasal trauma patients. Study design: A case-control study. Methods: In total, 27 children who presented with traumatic nasal injuries (patient group) and 31 healthy children with no history of craniofacial trauma that were matched to the patient group in terms of age and sex (control group) were included (38 males and 20 females, mean age of 6.49 ± 2.57 [range: 4-12] years). To identify any dimensional problem behaviors in the children, parents were asked to complete the Child Behavior Checklist for ages 4-18 years (CBCL/4-18), and the parents also completed the Family Assessment Device (FAD) to evaluate familial functioning and health. Results: Mother’s education level was significantly lower in the patient group than in the control group (p = 0.004). Clinical psychiatric assessments based on the DSM-5 criteria revealed that 13 children in the patient group and 3 in the control group had ADHD diagnoses (p = 0.000, p < 0.05). Raw scores for the inattentiveness, aggressive behavior, and delinquency behavior subscales of the CBCL were higher in the patient group than in the control group (all p < 0.05). Additionally, behavioral control and general family functioning affected the children with a new diagnosis of ADHD. Conclusion: In conclusion, this is the first analysis of the relationship between traumatic nasal injuries and ADHD symptoms in children. These findings highlight the importance of performing a psychiatric referral on children who present with nasal trauma to obtain an early diagnosis and perform early treatment of ADHD and to assess other psychiatric issues, familial problems, and ways to improve societal mental health.