Citation

Asarnow RF, Newman N, Su E, Weiss RE. JAMA Pediatr. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, American Medical Association)

DOI

10.1001/jamapediatrics.2021.4281

PMID

34694335

Abstract

In Reply Das et al make important points about the clinical implications of adult-onset attention-deficit/hyperactivity disorder (ADHD), including ADHD after a traumatic brain injury (TBI). It is worth noting that, while useful descriptively, the diagnosis of ADHD provides little insight into the pathobiology that underlies ADHD symptoms. That a substantial number of patients with histories of severe TBI in our article presented with the same ADHD symptoms as children with primary ADHD without histories of TBI underscores this point. As Yeates et al1 noted in the editorial accompanying our article,2 "Secondary ADHD is…a common occurrence in other childhood disorders affecting the brain, including low birthweight, fetal alcohol, autism spectrum disorder, epilepsy, and various inflammatory disorders." To amplify a point made in our article, while the etiology of ADHD in children following a TBI is almost certainly organic, there are psychosocial risk factors (eg, learning and behavior problems and family discord) that predated the TBI that clearly persist afterward, as well as a variety of psychosocial factors arising from the child's TBI (eg, parental distress, psychological trauma, and missing school) that are often more important than the initial acute injury severity3,4 in determining long-term outcomes...

Language: en