Attention-deficit/hyperactivity disorder in children with constipation and fecal incontinence

There is some evidence of a relationship between attention-deficit/hyperactivity disorder (ADHD) and functional defecation disorders (FDDs), both of which are common in childhood. The aim of the study was to investigate the frequency of ADHD in children with fecal incontinence (FI) and functional constipation (FC).

This cross-sectional study was conducted on 99 children aged 4-14 years who met the Rome IV criteria to diagnose pediatric chronic FC with FI from January to May 2020. The ADHD was then assessed by the child and adolescent psychiatrist via clinical visits, DSM-5 and Conners Rating Scale (CRS). Pearson’s Chi-Square test and Mann-Whitney’s test were used to compare children with and without ADHD. A P value <0.05 was considered statistically significant.

According to DM-V and clinical visits, about 24 (24.2%) children with FC and FI were diagnosed with ADHD. Moreover, six and one of their relatives had anxiety/depression and schizophrenia, respectively. Children with ADHD were significantly male (83%, p= 0.009), older (p= 0.003), heavier (p= 0.005), first born (79%, P < 0.001) and premature (37%, P=0.01) with older mothers (p=0.01).

This study showed that there was a high prevalence of ADHD in children with FC and FI. Therefore, screening of suspected children is recommended.