Table 1.
Studies examining the relationship between atopic diseases and hyperactivity in the qualitative analysis.
| Study name | Outcome (95% CI) | Study design | Country/City | Ethnicity | Number of participants/Exposed group/Unexposed group | Age (mean of the exposed group)/sex (male, %) | Diagnostic criteria for ADHD | Atopic disease/method used for assessing atopic diseases | Adjustment for confounding factors |
|---|---|---|---|---|---|---|---|---|---|
| Yuksel et al. 200858 | Continuous data for HI and IN* | Cross-sectional | Manisa, Turkey | Not reported | 100/62/38 | 7–12 years (9.2)/57% | DSM-IV | Asthma/Physician’s diagnosis (GINA 2006) | No |
| Camfferman et al. 201026 | Continuous data for HI* and total ADHD symptoms* | Cross-sectional | South Australia, Australia | Not reported | 107/77/30 | 6–16 years (9.9)/46.72% | Conner’s Parent Rating Scale-Revised | Atopic dermatitis/Physician’s diagnosis (Hanifin and Rajka criteria) | Yes |
| Chang et al. 201359 | Continuous data for HI and IN | Cross-sectional | Seoul and Ilsan and Gwacheon in Gyeonggi-do province in Korea | Not reported | 575 | 3–7 years (4.8)/51.3% | CBCL | Atopic dermatitis, allergic rhinitis, and asthma/Physician’s diagnosis and questionnaire (ISAAC questionnaire and SCORAD index) | No |
| Goodwin et al. 201360 | OR of ADHD in children with asthma*(different grades of severity [moderate*]/persistent [remission* and late onset*]) | Cohort | Perth, Western Australia | Not reported | 2193/390/1803 | 5, 8, 10, 14, and 17 years/62.56% | CBCL | Asthma/Physician’s diagnosis (Australian Asthma Handbook) | Yes |
| Kim et al. 201461 | Continuous data for impulsivity and inattention (divided attention task*) | Cohort | Korea | Not reported | 1036/797/239 | 3–16 years (11.4)/69.88% | Computerized comprehensive attention test | Allergic rhinitis/skin prick test | Yes |
| Lee et al. 201462 | Continuous data for HI and IN* | Cross-sectional | Seoul, Korea | Not reported | 160/87/73 | 6–13 years (8.49)/39.4% | DSM-IV | Allergic rhinitis/physician’s diagnosis (ARIA guideline) | Yes |
| Yang et al. 201463 | Continuous data for HI* and IN* | Cross-sectional | Taipei, Taiwan | Not reported | 122/93/29 | 6–14 years (10.78)/52.2% | DSM-IV-TR | Allergic rhinitis/Physician’s diagnosis (ARIA 2008) + IgE test (MAST or Phadiatop tests) | Yes |
| Catal et al. 201664 | Continuous data for total ADHD symptoms* and percentage of psychiatric disorders determined by ECI-4* | Cross-sectional | Malatya, Samsun, Aydın, Istanbul, Turkey | Not reported | 154/80/74 | 3–5 years (4.03)/51.3% | ECI-4 | Atopic dermatitis/Physician’s diagnosis (Hanifin and Rajka criteria) | No |
| Hammer-Helmich et al. 201665 | Continuous data for total ADHD symptoms *© | Cross-sectional | Copenhagen, Denmark | Not reported | 9036/2433/6603 | 3–15 years (NA)/49.5% | SDQ | Eczema, asthma, and hay fever/Questionnaire (UK Working Party Criteria) | Yes |
| Strom et al. 201666 | OR of ADD/ADHD in children with atopic dermatitis* | Cross-sectional | U.S. Bureau of Census | Not reported | 180,799/17,277/163,522 | < 18 years (NA)/49.94% | Questionnaire | Atopic dermatitis, asthma, and allergic rhinitis/questionnaire | Yes |
| Yang et al. 201667 | Continuous data for HI* and IN* | Case–control | Taipei, Taiwan | Not reported | 99/68/31 | 6–14 years (9.25)/82.4% | DSM-IV | Allergic rhinitis/physician’s diagnosis + IgE test (MAST or Phadiatop tests) | Yes |
| Feng et al. 201768 | Continuous data for HI* and IN* | Cross-sectional | Wenzhou, China | Not reported | 643/248/320 | 6–12 years (9.25)/51.9% | DSM-IV | Allergic rhinitis/physician’s diagnosis (ARIA 2008) + skin prick test | Yes |
| Lin et al. 201745 | OR of ADHD (inattentive/Hyperactive impulsive/combined) in children with atopic dermatitis, asthma, allergic rhinitis (fever/active)* | Cross-sectional | Taiwan | Han Chinese | 2896/2235/661 | 9–10 years (10)/50.5% | SNAP-IV | Atopic dermatitis, asthma, and allergic rhinitis/questionnaire (ISAAC questionnaire) | Yes |
| Abd El-Hamid et al. 201869 | Prevalence of different grades of ADHD symptoms (mild, moderate, and severe) in children with or without atopic diseases* | Case–control | Cairo, Egypt | Not reported | 160/100/60 | 6–12 years (8.54)/81.25% | DSM-IV | Allergic diseases/physician’s diagnosis, skin prick test, and total IgE enzyme immunoassay (ELISA) | No |
| Kuniyoshi et al. 201870 | Continuous data for total ADHD symptoms©* | Cross-sectional | Miyagi Prefecture, Japan | Not reported | 9954/1641/8313 | 7–14 years (10.42)/49.9% | SDQ | Eczema/ISAAC (Eczema symptom questionnaire) | Yes |
| Schmitt et al. 20186 | Continuous data for HI and IN* | Case–control | Dresden, Germany | Not reported | 89/35/45 | 6–12 years (9.9)/62.9% | ICD-10 | Atopic dermatitis/dermatologist’s diagnosis (UK Working Party Criteria) | Yes |
| Cices et al. 201971 | Continuous data for HI and IN* | Case–control | US, Chicago, Illinois | Caucasian (31.43%) African American (22.86%) Hispanic (20%) Asian (20%) Other (5.71%) | 35/17/18 | 6–16 years (11.07)/65.7% | Standardized Vanderbilt questionnaires | Atopic dermatitis/SCORAD | Yes |
| Tajdini et al. 201972 | Prevalence of ADHD in patients with asthma and controls* | Case–control | Tehran, Iran | Not reported | 171/79/92 | 5–11 years (7.54)/57% | Child Symptom Inventory-4 (CSI-4) | Asthma/respiratory function test | Yes |
| Zhou et al. 201973 | Prevalence of ADHD in patients with asthma and controls* | Cross-sectional | Guiyang, China | Han (77.59%) | 522/261/261 | 6–16 years (9.35)/61.69% | Mini-International Neuropsychiatric Interview for children and adolescents | Asthma/physician’s diagnosis (Bronchial Asthma Diagnostic and Prevention Guide for Children [2016 version]) | Yes |
| Feng et al. 202074 | Continuous data for HI* and IN* | Cross-sectional | Chongqing, China | Not reported | 273/89/184 | 6–12 years (8.3)/62.63% | SNAP-IV | Atopic dermatitis/dermatologist’s diagnosis (UK criteria) | Yes |
| Fuhrmann et al. 202075 | HR of ADD/ADHD in children with atopic dermatitis* | Cohort | Germany | Not reported | 37,235/9257/27,978 | From 0 to 7–9 years/51.7% | ICD-10 | Atopic dermatitis/ICD-10 | Yes |
| Guo et al. 202076 | Continuous data for HI (AR, AD, and asthma) and IN (AR*, AD, and asthma*) | Cohort | Kaohsiung, Taiwan | Not reported | 97 | 6 years/54.6% | SNAP-IV | Atopic dermatitis, asthma, and allergic rhinitis/ISAAC questionnaire, physician’s diagnosis (Hanifin–Rajka criteria), and IgE test | Yes |
| Huang et al. 202077 | OR of ADD/ADHD in children with atopic dermatitis* | Cross-sectional | US Northeast (17.96%) North Central (19.33%) South (45.83%) West (16.42%) Unknown (0.47%) | Not reported | 203,533/86,969/116,564 | 0–17 years (5.3)/51.74% | ICD-10-CM | Atopic dermatitis/IBM MarketScan Commercial Claims database (ICD-10-CM code for AD: L20*) | Yes |
| Jackson-Cowan et al. 202078 | OR of ADD/ADHD in children with atopic dermatitis* | Cross-sectional | US Northeast (15.73%) North Central (20.27%) South (36.21%) West (27.78%) | White (48.44%) Black (15.38%) Hispanic (27.86%) Asian (6.06%) Native American (0.97%) Other (1.29%) | 109,482/13,398/96,084 | 2–17 years/51.48% | Questionnaire | Atopic dermatitis/questionnaire | Yes |
| Kuo et al. 202041 | Continuous data for HI* and IN | Cross-sectional | Kaohsiung, Taiwan | Not reported | 191/109/92 | (6.59)/54.44% | SNAP-IV | Atopic dermatitis, asthma, and allergic rhinitis/physician’s diagnosis | Yes |
| Minatoya et al. 202079 | Continuous data for total ADHD symptoms* | Cross-sectional | Hokkaido, Japan | Not reported | 3862/799/3063 | (5.28)/49.9% | SDQ | Atopic dermatitis/ISAAC | Yes |
| Montalbano et al. 202080 | Continuous data for total ADHD symptoms * | Cross-sectional | Florence, Italy | Not reported | 141 | 6–11 years (10)/61.7% | SDQ | Asthma/GINA | Yes |
| Sollander et al. 202081 | OR of ADD/ADHD symptoms in children with atopic dermatitis* | Cross-sectional | Uppsala, Sweden | Not reported | 4451/397/4054 | 3–5 years (4.34)/50.42% | SDQ | Asthma/questionnaire | Yes |
| Wan et al. 202082 | OR of significant ADD/ADHD symptoms in children with atopic dermatitis* | Cross-sectional | US | White (66.6%)Black (20.9%)Indian (0.9%)Asian (5.3%)Multiracial (6.3%) | 57,726,856/6,807,687/50,919,169 | (10.08)/48.6% | SDQ | Atopic dermatitis/questionnaire | Yes |
| Berzosa-Grande et al. 202119 | Continuous data for IN* | Cross-sectional | Madrid, Spain | Not reported | 366/194/172 | 6–11 years (8.68)/52.7% | CBCL | Asthma, atopic dermatitis, allergic rhinitis/questionnaire | No |
| Chai et al. 202183 | OR of comorbidity of ADHD and Asthma* | Cross-sectional | Canada | Not reported | 768,460/28,729/158,064 | (8.7)/45.8% | ICD-10 | Asthma/clinical physician’s diagnosis | No |
| Galéra et al. 202184 | Continuous data for ADHD symptoms* | Cohort | Canada | Not reported | 2120 | 1.5, 2.5, 3.5, 4.5, 5, 6, 7, 8, 10, 13, 15, 17 years/50.9% | Behavioral ratings of ADHD symptoms | Asthma, eczema/Code of database (Quebec Longitudinal Study of Child Development (QLSCD)) | Yes |
| Hou et al. 202185 | OR of ADD/ADHD in children with atopic dermatitis* | Cross-sectional | US | Not reported | 228,898/23,353/205,545 | < 17 years/50.2% | database | Atopic dermatitis/questionnaire | Yes |
| Keller et al. 202186 | Association between asthma, atopic dermatitis* and ADHD symptoms | Cross-sectional | Leipzig, Germany | Not reported | 1764 | 2.53–10.49 years(6.1)/53.1% | SDQ | Asthma, atopic dermatitis/questionnaire | No |
| Özyurt et al. 202187 | Continuous data for ADHD symptoms* | Cross-sectional | Izmir, Turkey | Not reported | 121/61/60 | 12–18 years (14.27)/47.54% | SDQ | Asthma/GINA (2017) | No |
| Rajhans et al. 202188 | Continuous data for IN* | Cross-sectional | North India | Not reported | 60/30/30 | 8–15 years (11.92)/70% | M.I.N.I. KID, CBCL | Asthma/GINA (2015) | Yes |
| Vittrup et al. 202189 | HR of ADHD in children with atopic dermatitis* | Cohort | Denmark | Not reported | 157,113/14,283/142,830 | 0–18 years/57% | Codes of database | Atopic dermatitis/clinical physician’s diagnosis | Yes |
| Yüksel et al. 202190 | Continuous data for HI* and IN in ADHD children with or without asthma | Cross-sectional | Izmir, Turkey | Not reported | 355/91/264 | 2–6 years | ADHD Rating Scale-IV, K-SADS-PL | Asthma/questionnaire | Yes |
ADHD, Attention-Deficit/Hyperactivity Disorder; OR, Odds Ratio; HI, Hyperactivity/Impulsivity; IA, Inattention; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders; GINA 2006, Global Initiative for Asthma, 2006; CBCL, Child Behavior Checklist; ARIA, Allergic Rhinitis and its Impact on Asthma; MAST, multiple-antigen simultaneous test; ECI-4, The Early Childhood Inventory-4; ADD, Attention deficit disorder; SDQ, Strengths and Difficulties Questionnaire; ICD-10, International Classification of Diseases, Tenth Revision; SCORAD, SCORing Atopic Dermatitis; ISAAC, International Study of Asthma and Allergies in Childhood; M.I.N.I. KID, Mini-International Neuropsychiatric Interview for Children and Adolescents; K-SADS-PL; Schedule for Affective Disorders and Schizophrenia for School-Aged Children—Present and Lifetime Version © Calculated from the available information in the article. *Statistically significant.