Helin Yilmaz Kafali,Elif Demirkilinc Biler,Melis Palamar,Burcu Ozbaran.[J].Chin J Traumatol,2020,23(2):71-77. [doi]

Ocular injuries, attention deficit and hyperactivity disorder, and maternal anxiety/depression levels: Is there a link?

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KeyWord: Attention deficit and hyperactivity disorderChildOcular traumaPenetrating eye injuryMaternal anxiety

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Author Name	Affiliation
Helin Yilmaz Kafali	Department of Child and Adolescent Psychiatry, Ankara City Hospital, Ministry of Health, Ankara, Turkey
Elif Demirkilinc Biler	Department of Ophthalmology, Ege University School of Medicine, Izmir, Turkey
Melis Palamar	Department of Ophthalmology, Ege University School of Medicine, Izmir, Turkey
Burcu Ozbaran	Department of Child and Adolescent Psychiatry, Ege University School of Medicine, Izmir, Turkey

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Abstract:

Purpose: Given the increased risk of accidents in patients with attention deficit and hyperactivity disorder (ADHD) or maternal anxiety/depression, we aimed to investigate the frequency of the two diseases in children with penetrating eye injury (PEI). Methods: Altogether 79 children, 39 with PEIs and 40 healthy individuals (control group), aged 5-15 years, underwent a complete ophthalmologic examination. Afterwards, schedule for affective disorders and schizophrenia for school-aged children was conducted to assess the psychiatric diagnosis of all children. Turgay diagnostic and statistical manual of mental disorders (DSM-IV)-based child and adolescent behavior disorders screening and rating scale (T-DSM-IV-S) was filled by parents to evaluate the severity of ADHD symptoms. The depression and anxiety levels of mothers of each group were evaluated by two self-report measures: the Beck depression scale and the state-trait anxiety inventory (STAI), respectively. Data were analyzed by IBM SPSS version 22.0. The Chi-square and Fisher's exact test were used to determine whether there is a significant difference between qualitative variables while independent sample t and Mann-Whitney U tests to compare quantitative variables. Results: The only diagnostic difference was a significantly higher frequency of ADHD among patients with PEIs (48.7% in PEI vs. 17.5% in control group, x² = 7.359, p = 0.007). The total scores of the T-DSM-IVS (attention subscale U = 418.000, p = 0.006; hyperactivity subscale U = 472.000, p = 0.022) and maternal state-trait anxiety inventory (maternal STAI-state U = 243.000, p = 0.003; maternal STAI-trait U = 298.000, p = 0.021) were significantly higher in the PEI group than in control group. In logistic regression, children with PEI had a tendency to have a 3.5-fold increased risk for ADHD (OR = 3.538, CI = 0.960-13.039, p = 0.058). Conclusion: ADHD was detected almost 1 in 2 children with PEIs. Besides, the maternal anxiety level was significantly higher in the PEI group than in the control group. This association should be further explored via a future prospective longitudinal study. Since a proper treatment of ADHD in children and anxiety treatment in mothers may prevent vision loss following PEIs in children.

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