A preliminary study: relationship between inattention/hyperactivity and familial mediterranean fever in children and adolescents

ABSTRACT

Although Familial Mediterranean Fever (FMF) progresses with attacks, its subclinical inflammation may continue in attack-free periods. To date, increased inflammatory cytokines have been reported in many psychiatric diseases. In this study, we aimed to evaluate the psychological symptoms, especially inattention/hyperactivity, in patients with FMF. The study included 272 children and adolescents with FMF and 250 healthy peers as a control group. The Strengths and Difficulties Questionnaire-Parent Form was used to assess emotion, behavior and peer related problems, as well as inattention/hyperactivity and prosocial behavior in participants. The age and gender of the children were similar across groups. The emotional and behavioral problem subscale scores of patients with FMF were significantly higher than those of healthy controls. The inattention/hyperactivity scores of patients with FMF were also significantly higher than those of the control group (3.99 ± 2.34 vs 2.93 ± 2.26, p < 0.001). When patients with FMF were compared according to the presence of attacks in the last year, presence of exertional leg pain, no differences were found in terms of inattention/hyperactivity scores. However, patients whose FMF symptoms started before 6 years of age had significantly higher inattention/hyperactivity scores than those whose symptoms begun after 6 years of age. This research demonstrated that FMF patients had increased inattention/hyperactivity, which was unaffected by FMF-related variables, except for age of onset. The FMF-inattention/hyperactivity relationship may be due to a common etiology in which proinflammatory cytokines play a role.

KEYWORDS:

• Adolescents
• attention deficit hyperactivity disorder
• children
• familial mediterranean fever
• inflammation

Acknowledgments

We wish to thank all the patients who participated in this study and their parents, as well as the staff of the participating center.

Author contributions

GD, MTK, and KB conceptualized and designed the study, drafted the initial manuscript, and had full access to all the data in the study; ZK, SS and AA designed the study, conducted the data analyses, drafted the initial manuscript, and had full access to all the data in the study; GD, HD, FH and MY drafted the initial manuscript; BD, FH and OK conceptualized and designed the study, drafted the final manuscript, and had full access to all the data in the study and all authors reviewed and revised the manuscript and approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Compliance with ethical standards

The study was reviewed and approved by the local ethical committee.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.