{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:38:35Z","timestamp":1789123115007,"version":"build-2803163510"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Pediatric pain significantly affects children\u2019s lives, leading to school absenteeism, impaired social interactions, and psychological distress. The perception of sensory signals as pain is influenced by the brain\u2019s noradrenergic system, and recent evidence suggests that chronic pain may impact cognitive functioning and emotional regulation. Attention-Deficit\/Hyperactivity Disorder (ADHD) is associated with alterations in the dopaminergic\/noradrenergic systems, which could affect pain perception. Pain-associated conditions and frequent analgesic use in childhood may be linked to ADHD development and could serve as early indicators, yet data on this potential association remain limited. Study Aim: This population-based case-control study in Israel aimed to assess the prevalence of pain-related diagnoses prior to ADHD diagnosis in children aged 5 to 18. The study included children registered with Leumit Health Services (LHS) between 1 January 2006, and 30 June 2021. Children diagnosed with ADHD were compared to matched controls, selected based on age, gender, socioeconomic status, and other sociodemographic factors, who were never diagnosed with ADHD during the study period. Results: Children with ADHD (N = 18,756) and controls (N = 37,512) were precisely matched for sociodemographic characteristics. Individuals with ADHD exhibited significantly higher frequencies of diverse pain conditions, including those associated with illness [headache, earaches, and throat pain (odds ratios [OR] = 1.156 [95%CI 1.085, 1.232], 1.295 [95%CI 1.217, 1.377], and 1.080 [95%CI 1.019, 1.145], respectively; p &lt; 0.01)] and injury [sprains and strains (OR = 1.233 [95% CI 1.104,1.376)]. Analgesics were more frequently purchased by individuals with ADHD, particularly paracetamol (OR = 1.194 [95%CI 1.152, 1.237], p &lt; 0.001) and ibuprofen (OR = 1.366 [95%CI 1.318, 1.416], p = 0.001). Conclusions: This study highlights a potential connection between ADHD and pediatric pain. The elevated rates of pain diagnoses and analgesic usage among children with ADHD underscore the need for further research.<\/jats:p>","DOI":"10.3390\/children11111388","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T04:47:17Z","timestamp":1731646037000},"page":"1388","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pain-Associated Diagnoses in Childhood Before the Diagnosis of Attention-Deficit\/Hyperactivity Disorder: A Population-Based Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5469-0236","authenticated-orcid":false,"given":"Eugene","family":"Merzon","sequence":"first","affiliation":[{"name":"Adelson School of Medicine, Ariel University, Ariel 4070000, Israel"},{"name":"Leumit Health Services, Tel-Aviv 6473817, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7713-423X","authenticated-orcid":false,"given":"Eli","family":"Magen","sequence":"additional","affiliation":[{"name":"Leumit Health Services, Tel-Aviv 6473817, Israel"},{"name":"Medicine A Department, Assuta Ashdod Medical Center affiliated with the Ben Gurion, University of the Negev, Beer Sheva 8410501, Israel"},{"name":"Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 8410501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaniv","family":"Levy","sequence":"additional","affiliation":[{"name":"Leumit Health Services, Tel-Aviv 6473817, Israel"},{"name":"Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Institute of Pain Medicine, Sheba Medical Center, Ramat Gan 5262000, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7244-0679","authenticated-orcid":false,"given":"Shai","family":"Ashkenazi","sequence":"additional","affiliation":[{"name":"Adelson School of Medicine, Ariel University, Ariel 4070000, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0642-0028","authenticated-orcid":false,"given":"Iris","family":"Manor","sequence":"additional","affiliation":[{"name":"ADHD Unit, Geha Mental Health Center, Petah Tikva 491000, Israel"},{"name":"Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9765-8938","authenticated-orcid":false,"given":"Abraham","family":"Weizman","sequence":"additional","affiliation":[{"name":"ADHD Unit, Geha Mental Health Center, Petah Tikva 491000, Israel"},{"name":"Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4046-8305","authenticated-orcid":false,"given":"Beth","family":"Krone","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen V.","family":"Faraone","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY 13210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9435-7152","authenticated-orcid":false,"given":"Ilan","family":"Green","sequence":"additional","affiliation":[{"name":"Leumit Health Services, Tel-Aviv 6473817, Israel"},{"name":"Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avivit","family":"Golan-Cohen","sequence":"additional","affiliation":[{"name":"Leumit Health Services, Tel-Aviv 6473817, Israel"},{"name":"Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomo","family":"Vinker","sequence":"additional","affiliation":[{"name":"Leumit Health Services, Tel-Aviv 6473817, Israel"},{"name":"Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4389-8896","authenticated-orcid":false,"given":"Ariel","family":"Israel","sequence":"additional","affiliation":[{"name":"Leumit Health Services, Tel-Aviv 6473817, Israel"},{"name":"Department of Epidemiology and Disease Prevention, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0304-3959(00)00269-4","article-title":"Pain in children and adolescents: A common experience","volume":"87","author":"Perquin","year":"2000","journal-title":"Pain"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.jpain.2022.12.007","article-title":"Chronic Pain and High Impact Chronic Pain in Children and Adolescents: A Cross-Sectional Study","volume":"24","author":"Castarlenas","year":"2023","journal-title":"J. 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