No increased risk of attention deficit hyperactivity disorders in patients with Hirschsprung disease

J Pediatr Surg. 2019 Oct;54(10):2024-2027. doi: 10.1016/j.jpedsurg.2018.10.067. Epub 2018 Nov 7.


Purpose: Hirschsprung disease (HSCR) has previously been associated with increased need of special education services despite normal intelligence. The aim of this study was to assess the risk of attention deficit hyperactivity disorders (ADHD) in individuals with HSCR in a population-based cohort.

Methods: This was a nationwide, population-based cohort study. The study exposure was HSCR and the study outcome was ADHD. The cohort included all individuals with HSCR registered in the Swedish National Patient Register between 1964 and 2013 and ten age- and sex-matched controls per patient, randomly selected from the Population Register.

Results: The cohort comprised 739 individuals with HSCR and 7390 controls. Twenty-six of the 739 individuals with HSCR and 202 of the 7390 controls were diagnosed with ADHD, Odds ratio (OR) 1.30, Confidence interval (CI) 95% 0.84-1.93, indicating no difference in risk for ADHD. The mean age at diagnosis of ADHD was not different between the groups; 18.1 years (SD 8.4) vs 16.7 years (SD 7.8), p = 0.39. Down syndrome did not affect the risk for ADHD, OR 2.26 (CI 95% 0.68-5.53). Female gender decreased the risk for ADHD, OR 0.58 (CI 95% 0.40-0.83).

Conclusions: There is no increased risk of ADHD in patients with Hirschsprung disease.

Level of evidence: Prognosis study, level of evidence: Level I.

Keywords: ADHD; Attention deficit hyperactivity disorders; Epidemiology; Hirschsprung's disease.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / etiology*
  • Child
  • Child, Preschool
  • Female
  • Hirschsprung Disease / complications*
  • Hirschsprung Disease / psychology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Population Surveillance / methods*
  • Registries*
  • Sweden / epidemiology
  • Young Adult