SEARCHCOHORTpediatrics, psychiatry

cohort·pediatrics, psychiatry, epidemiology, public health, pediatric ophthalmology·PMC10445352

Can a nation-wide e-cohort of ADHD and ASD in childhood be established using Welsh routinely available datasets?

BMJ Open · 7 authors, 8 centres

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TL;DR

This study evaluated the feasibility of creating a nationwide electronic cohort of individuals with childhood ADHD and/or ASD using linked Welsh healthcare records.

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These were compared to matched controls and a directly assessed ADHD sample. Cox regression analyses assessed associations with service use for anxiety/depression, self-harm, substance use, and emergency department contact in young adulthood. The ADHD cohort showed significantly higher risks for all outcomes, including a fivefold increase in self-harm. The ASD cohort had increased risks for anxiety/depression, self-harm, and drug use, but not alcohol use. The study demonstrates a valid method for establishing large, low-attrition e-cohorts for longitudinal research on ADHD and ASD.

STUDY TYPE

cohort

SPECIALTY

pediatrics

SUMMARISED BY

AI pipeline

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ORIGINAL PAPER

PMC10445352

Can a nation-wide e-cohort of ADHD and ASD in childhood be established using Welsh routinely available datasets?

BMJ Open

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ABSTRACT

Abstract Objectives We investigated the feasibility and validity of establishing a nationwide e-cohort of individuals with a diagnosis of attention deficit hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) for future longitudinal research. Design Individuals with a childhood diagnosis of ADHD/ASD as recorded on routinely available healthcare datasets were compared with matched controls and a sample of directly assessed individuals with ADHD. Setting This study used data from the Welsh Secure Anonymised Information Linkage Databank in Wales, UK. Routinely collected data from primary care, emergency department and hospital admissions were linked at person level. Participants All individuals in Wales, UK born between 1 January 1991 and 31 December 2000. Individuals with a recorded diagnosis of ADHD and/or ASD by age 18 years were identified using International Classification of Diseases, 10th Revision and National Health Service (NHS) READ codes and matched to 3 controls each and 154 individuals with ADHD recruited from an established research study. Outcome measures Recorded service use for anxiety and depression, alcohol and drug use and self-harm including emergency department use in young adulthood (age 16–25 years). Results 7726 individuals had a recorded diagnosis of ADHD (80% male) and 5001 of ASD (79% male); 1.4% and 0.9% of the population, respectively. Cox’s regression analyses showed ADHD was associated with increased risks of anxiety/depression (HR: 2.36, 95% CI: 2.20 to 2.53), self-harm (HR: 5.70, 95% CI: 5.07 to 6.40), alcohol (HR: 3.95, 95% CI: 3.42 to 4.56), drug use (HR: 5.88, 95% CI: 5.08 to 6.80) and emergency department service use (HR: 1.36, 95% CI: 1.31 to 1.41). Those with ASD were at increased risk of anxiety/depression (HR: 2.11, 95% CI: 1.91 to 2.34), self-harm (HR: 2.93, 95% CI: 2.45 to 3.50) and drug use (HR: 2.21, 95% CI: 1.66 to 2.95) but not alcohol use. The ADHD e-cohort were similar to the directly assessed cohort. Conclusions Our identification strategy demonstrated the feasibility of establishing a large e-cohort of those with ADHD/ASD with expected patterns of poorer early adult outcomes, demonstrating a valid method of identifying large samples for future longitudinal studies without selective attrition. Keywords: mental health, community child health, child & adolescent psychiatry, depression & mood disorders, substance misuse, suicide & self-harm

CITATION EXPORT

Kate Langley, Marcos Del Pozo-Banos, Søren Daalsgard et al.. Can a nation-wide e-cohort of ADHD and ASD in childhood be established using Welsh routinely available datasets?. BMJ Open. (2023). https://doi.org/10.1136/bmjopen-2023-071851

AUTHORS

7 · 8 CENTRES

Kate Langley, Marcos Del Pozo-Banos, Søren Daalsgard, Shantini Paranjothy, Lucy Riglin, Ann John, Anita Thapar

1School of Psychology, Cardiff University, Cardiff, UK
2Population Data Science, Swansea University, Swansea, UK
3Wolfson Centre for Young People’s Mental Health, Cardiff University, Cardiff, UK
4National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
5Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
6Department of Child and Adolescent Psychiatry, Mental Health Services of the Capital Region, Glostrup, Denmark
7Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
8Division of Psychological Medicine and Clinical Neurosciences; Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, UK