D2.75 - Prevalence of Attention Deficit Hyperactivity Disorder and Related Factors in Children Aged 6-14 Years Diagnosed with Allergic Rhinitis

Attention deficit hyperactivity disorder (ADHD) and allergic rhinitis (AR) are common childhood disorders that negatively impact quality of life. It is known that AR symptoms can impair sleep quality, leading to fatigue and decreased cognitive function. The literature reports that ADHD is more common in children with AR. This study aimed to compare the frequency of ADHD symptoms in children diagnosed with AR with healthy controls and to investigate its relationship with clinical factors such as disease severity and duration, as assessed by both parents and teachers.

The study included 110 patients aged 6-14 years diagnosed with AR and 112 healthy controls. The AR diagnosis was made according to the ARIA guidelines. ADHD symptoms were assessed using the SNAP-IV scale with both parent and teacher forms. The total score obtained from the inattention and hyperactivity/impulsivity subscales was divided by 18 to calculate the inattention/hyperactivity scale (IHS); IHS>1.25 was considered positive for ADHD symptoms.

The IHS>1.25 ratio was higher in the AR group compared to the healthy group (9.1% vs. 6.2%), but this did not reach statistical significance. The hyperactivity/impulsivity subscore was significantly higher in the AR group (5.85±4.88 vs. 4.85±4.80, p=0.045). The teacher form was completed in 36.4% of the AR group and 26.8% of the healthy group; no difference was found between the groups in this assessment. Moderate agreement was observed between parent and teacher assessments (r=0.445, p<0.001); families reported significantly higher scores (p=0.001). In subgroup analyses, the SNAP-IV ADHD score was significantly higher in children with moderate-severe AR compared to mild AR (13.24±10.06 vs 9.25±6.33, p=0.046). A positive correlation was found between the TNSS (Total Nasal Symptoms Score) and the attention deficit score (r=0.246, p=0.010) and between the duration of complaints and attention deficit (r=0.227, p=0.017). The ADHD score was significantly higher in boys than in girls (p=0.006). 

Although AR alone does not significantly increase ADHD symptoms, disease severity and symptom duration have been found to be associated with attention deficit. The significantly high ADHD scores in moderate-severe AR indicate that the symptom burden may negatively affect cognitive processes. The consistent but varying levels of parent and teacher reports highlight the importance of multi-source assessment. These findings emphasize the need for neuropsychiatric evaluation of children with moderate-to-severe AR and chronic symptoms.