Bidirectional associations between hyperopia, myopia, astigmatism, and strabismus, and attention-deficit/hyperactivity disorder in children: a national population-based cohort study

Objectives: The present study analyzed the reciprocal relationships between four common pediatric ophthalmic diseases (i.e., hyperopia, myopia, astigmatism, and strabismus) and attention‐deficit/hyperactivity disorder (ADHD) in children. Methods: This study enrolled 86,028 children with ADHD and 1,798,673 children without ADHD in the Taiwan Maternal and Child Health Database who were born at any time from 2004 to 2017. Cox proportional hazards regression models were used to estimate the bidirectional relationships of the four ophthalmic diseases with ADHD in children after adjusting for age, sex, and gestational age at birth. Survival curves for time-to-event variables were estimated using the Kaplan-Meier method, and the log-rank test was used to compare the curves. Results: The results indicated that ADHD significantly predicted the occurrence of hyperopia, myopia, astigmatism, and strabismus. Furthermore, hyperopia, myopia, astigmatism, and strabismus significantly predicted the occurrence of ADHD. The time between enrollment and ADHD diagnosis was shorter for patients with ophthalmic diseases than for the control group, and the time between enrollment and ophthalmic disease diagnosis was also shorter for ADHD patients than for the control group. Sex differences were found in the associations between ADHD and ophthalmic diseases. Conclusion: Clinicians should monitor children with ADHD for hyperopia, myopia, astigmatism, and strabismus to ensure appropriate treatment, and vice versa.

Relationships of homophobic bullying during childhood and adolescence with problematic internet and smartphone use in early adulthood among sexual minority men in Taiwan

Abstract Background Mental health disparity in sexual minorities is a crucial clinical and public health issue worldwide. A total of 500 homosexual or bisexual men aged between 20 and 25 years participated in this study. Objectives The aims of the study were to examine the relationships of victimization of traditional and cyber homophobic bullying during childhood and adolescence with problematic internet and smartphone use and activities during early adulthood among sexual minority men in Taiwan. Methods The seveirities of problematic internet and smartphone use and activities in early adulthood were compared between victims and non-victims of bullying. The severities of problematic internet and smartphone use were also compared among the groups of various types of bullying as well as among the groups of various persistence durations of being bullied. Results Victims of traditional and cyber homophobic bullying had more severe problematic internet and smartphone use than non-victims. Victims of multi-type bullying had more severe problematic internet use than victims of single-type bullying. Prolonged victimization was significantly associated with problematic internet and smartphone use. Discussion: Victimization of traditional and cyber homophobic bullying during childhood and adolescence predicts problematic internet and smartphone use during early adulthood among sexual minority men.

Persistent and multisite homophobic harassment during childhood and adolescence and its association with school difficulties in gay and bisexual men in Taiwan

Abstract Background: Homophobic harassment can compromise mental health of sexual minority youths. Objectives: This study examined the rates of persistent and multisite homophobic harassment and their associations with school difficulties during childhood and adolescence among gay and bisexual men in Taiwan. Methods: Participants were recruited through advertisements on the Facebook, Bulletin Board Systems, and the home pages of health promotion and counseling centers for the gay, lesbian, and bisexual community. The experiences of traditional and cyber harassment based on gender role nonconformity and sexual orientation of 500 gay or bisexual men were examined. The associations of multisite and persistent harassment victimization with school difficulties were evaluated. Results: A total of 239 (47.8%) and 131 (26.2%) participants experienced persistent and multisite harassment victimization, respectively. Harassment victimization was significantly associated with low satisfaction with academic performance in any stage of study. Moreover, the participants who were harassed in senior high schools were more likely to miss classes or be truant than those who were not harassed. The victims of multisite harassment at senior high schools were more likely to miss classes or be truant than those of school-only harassment. Discussion: Prevention and intervention programs are warranted to reduce homophobic harassment in sexual minority youths.

Pain-related quality of life related to mental health and sociodemographic indicators in adolescents

Abstract Background A total of 6150 junior and senior high school students aged 11-18 years participated in this study. Their level of pain-related QOL was assessed using the pain subscale of the Taiwanese QOL Questionnaire for Adolescents. The severities of depression, suicidality, anxiety, and alcohol abuse were also examined. Objectives This study examined the associations between pain-related quality of life (QOL) and sociodemographic characteristics and those between pain-related QOL and mental health problems such as depression, suicidality, anxiety, and alcohol abuse. Methods The association of sociodemographic factors with pain-related QOL was examined through multiple regression analysis. The association of pain-related QOL with mental health problems was examined through logistic regression analysis. Results The boys exhibited a higher level of satisfaction with pain-related QOL than did the girls. Older age was significantly associated with a lower level of satisfaction with pain-related QOL. Residential background, parental marital status, and parental education levels were not significantly associated with the level of satisfaction with pain-related QOL. Increased risks of depression, suicidality, anxiety, and alcohol abuse were significantly associated with a low level of satisfaction with pain-related QOL. Discussion A low level of satisfaction with pain-related QOL is significantly associated with the risk of poor mental health. Adolescents with the correlates of low satisfaction with pain-related QOL should be monitored for the risk of mental health problems.