J Clin Res Gov 2 (2013) 17–21 17 Swedish Science Pioneers Developing World Journal Series Journal of Clinical Research & Governance www.jcrg.sciencepub.se Research article Association between Adult Attention Deficit-Hyperactivity Disorder and Motorcycle Traffic Injuries in Kerman, Iran: A Case-control Study Saeid Safiri a , Homayoun Sadeghi-Bazargani b,c , Shahrokh Amiri d , Narges Khanjani e , Hamid Safarpour f , Nahid Karamzad g , Ali Akbar Haghdoost h a: Student Research Committee, Department of Epidemiology and Biostatistics, Faculty of Health, Kerman University of Medical Sciences, Kerman, Iran b: Road Traffic Injury Research Center, Department of Statistics & Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran c: WHO Collaborating Centre on Community Safety Promotion, Karolinska Institute, Stockholm, Sweden d: Clinical Psychiatry Research Center, Department of Psychiatry, Tabriz University of Medical Sciences, Tabriz, Iran e: Department of Epidemiology and Biostatistics, Faculty of Health, Kerman University of Medical Sciences, Kerman, Iran f: Department of Nursing, Faculty of Nursing & Midwifery, Kerman University of Medical Sciences, Kerman, Iran g: Department of Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran h: Department of Epidemiology, Kerman University of Medical Sciences, Kerman, Iran Correspondence Ali Akbar Haghdoost Professor of Epidemiology, Kerman University of Medical Sciences, P.O. Box: 76175-531, Kerman, Iran Tel: +98 9133439427 Fax: Fax: +98 (0341) 3205127 E-mail: ahaghdoost@kmu.ac.ir Keywords: Attention Deficit-Hyperactivity Disorder Adult ADHD Traffic injuries Motorcycle injuries Motorbike injuries Road traffic accidents Risk factors Epidemiology Abstract Purpose: To assess the association between adult Attention Deficit-Hyperactivity Disorder(ADHD) and motorcycle rider traffic injuries Methods: A case-control study was conducted over a period of six months in 2012. Two hundred and five motorcycle riders involved in traffic accidents, and 200 age-matched non-traumatic controls were enrolled. The Conners’ Adult ADHD Rating Scale (CAARS) self-report (screening version) was used for screening in both groups. Finally the score of ADHD was compared between the groups and associations were assessed using multivariate logistic regression analysis. Results: Two hundred and five males were recruited with a mean age of 24.3±10.2 years in the case and 25.0 ±7.7 years in control groups. Univariate Analysis showed significant association with educational level, job, daily riding amount, driving at night, helmet usage, motorcycle engine size, household income, individual income and socio-economic status. In all ADHD subscales (A,B,C,D), significant associations were found and all subscale scores were higher in the case group. Multivariate analysis confirmed the association of ADHD screening score with motorcycle traffic injuries. Conclusion: The results indicated existance of an association between Adult ADHD and motorcycle traffic injuries. ©2013Swedish Science Pioneers, All rights reserved. Introduction Injuries account for about 12% of the world’s burden of disease [1]. Irrespective of their intent or cause, injuries comprise a major impact to be left on the health system which in turn is responsible for the care and support of the victims. Researchers believe that about 98% of these cases are preventable [2]. Among the injuries, unintentional ones account for 63 % of injury deaths, with suicide and homicide accounting for 21 %and 13 %, respectively [3]. Despite some success in reducing the age-adjusted injury death rate by 21 % between 1980 and 1997, injury from intentional and unintentional causes remains the leading cause of death for children, adolescents, and young adults which is the fourth leading cause of death over all age groups [3]. Among unintentional injuries, road traffic accidents with 53.5% of cases are considered the most prevalent in this regard [4]. About 85% of the deaths and 90% of the Disability-Adjusted Life Years (DALYs) caused by road traffic accidents in the world, occur in Low and Middle Income Countries (LAMICs) [5]. Whereas in High Income Countries (HICs) car accidents are common, in LMICs, motorcycles, bicycles and pedestrian ones are common. Khatami et al. showed that motorcycle trauma is so common in Iran that motorcycle traffic injuries comprised 42 % of all extant traumas [6]. Motorcycle traffic injuries have multiple risk factors and some studies have indicated that there is an association between psychological disorders and road traffic injuries such as motorcycle accidents [7]. Among psychiatric disorders, Attention Deficit Hyperactivity Disorder (ADHD) has been neglected and often considered as a childhood disorder while epidemiological studies demonstrate that ADHD is the most common behavioral disorder of childhood and 50% to 80% of adults who had childhood ADHD, no longer meet full Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for the disorder, but continue to show some ADHD symptoms that cause impairment [8,9,10]. Longitudinal studies generally report persistence of ADHD among up to 50% of young adults [11].