View in EDS HTML Full Text PDF Full Text

The Association between Repeated Measured Febrile Episodes during Early Childhood and Attention Deficit Hyperactivity Disorder: A Large-Scale Population-Based Study

Saved in:
Bibliographic Details
Title: The Association between Repeated Measured Febrile Episodes during Early Childhood and Attention Deficit Hyperactivity Disorder: A Large-Scale Population-Based Study
Language: English
Authors: Ariel Israel, Eugene Merzon (ORCID 0000-0001-5469-0236), Beth Krone (ORCID 0000-0003-4046-8305), Stephen V. Faraone, Ilan Green, Avivit Golan Cohen, Shlomo Vinker, Shira Cohen, Shai Ashkenazi, Eli Magen, Abraham Weizman (ORCID 0000-0002-9765-8938), Iris Manor (ORCID 0000-0002-0642-0028)
Source: Journal of Attention Disorders. 2024 28(5):677-685.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 9
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Descriptors: Physiology, Young Children, Incidence, Attention Deficit Hyperactivity Disorder, Correlation, Children, Adolescents, Probability, Neurology, Foreign Countries
Geographic Terms: Israel
DOI: 10.1177/10870547231215289
ISSN: 1087-0547
1557-1246
Abstract: Objective: We examined the association between the number, magnitude, and frequency of febrile episodes during the 0 to 4 years of life and subsequent diagnosis of ADHD. Methods: This population-based case-control study in an Israeli HMO, Leumit Health Services (LHS), uses a database for all LHS members aged 5 to 18 years between 1/1/2002 and 1/30/2022. The number and magnitude of measured fever episodes during the 0 to 4 years were recorded in individuals with ADHD (N = 18,558) and individually matched non-ADHD controls in a 1:2 ratio (N = 37,116). Results: A significant, independent association was found between the number and magnitude of febrile episodes during the 0 to 4 years and the probability of a later diagnosis of ADHD. Children who never had a measured temperature >37.5°C had a significantly lower rate of ADHD (OR = 0.834, 95% CI [0.802, 0.866], p < 0.0001). Conclusions: Febrile episodes during 0 to 4 years are associated with a significantly increased rate of a later diagnosis of ADHD in a dose-response relationship.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1440635
Database: ERIC
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
    Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwH-pvejyrhpvxAcSoHGiwaVAAAA4jCB3wYJKoZIhvcNAQcGoIHRMIHOAgEAMIHIBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDNfetuhekrfdk7jL-gIBEICBmnxjd0o0V7BG7aYD49Cz6huOQ9hJKy3ixXywvbV5icHkN_8QAClOGEUQUZ6b1ViPMD5iQ6aQWCFYaHXRqYX86nzsZCTRD8a5FDQHUvjUqCoytOM9b0iCj2IYVTW7b-Q2pUOwL8hjwIO5wjP9wSKVU8hhnCwMzuWv-XcZiIG85XJGXKbo3jZaCuN4EZKqSg4_zgh-ulgGTQcxYsY=
Text:
  Availability: 1
  Value: &lt;anid&gt;AN0175968762;gs001mar.24;2024Mar14.04:50;v2.2.500&lt;/anid&gt; &lt;title id=&quot;AN0175968762-1&quot;&gt;The Association Between Repeated Measured Febrile Episodes During Early Childhood and Attention Deficit Hyperactivity Disorder: A Large-Scale Population-Based Study&#160;&lt;/title&gt; &lt;p&gt;Objective: We examined the association between the number, magnitude, and frequency of febrile episodes during the 0 to 4 years of life and subsequent diagnosis of ADHD. Methods: This population-based case-control study in an Israeli HMO, Leumit Health Services (LHS), uses a database for all LHS members aged 5 to 18 years between 1/1/2002 and 1/30/2022. The number and magnitude of measured fever episodes during the 0 to 4 years were recorded in individuals with ADHD (N = 18,558) and individually matched non-ADHD controls in a 1:2 ratio (N = 37,116). Results: A significant, independent association was found between the number and magnitude of febrile episodes during the 0 to 4 years and the probability of a later diagnosis of ADHD. Children who never had a measured temperature &amp;gt;37.5&#176;C had a significantly lower rate of ADHD (OR = 0.834, 95% CI [0.802, 0.866], p &amp;lt;.0001). Conclusions: Febrile episodes during 0 to 4 years are associated with a significantly increased rate of a later diagnosis of ADHD in a doseresponse relationship.&lt;/p&gt; &lt;p&gt;Keywords: ADHD; fever; childhood; neuro-inflammation; dose-dependent&lt;/p&gt; &lt;hd id=&quot;AN0175968762-2&quot;&gt;Introduction&lt;/hd&gt; &lt;p&gt;ADHD, a highly heritable, genetically conferred disorder, is the most common neurobiological disorder in childhood ([&lt;reflink idref=&quot;bib8&quot; id=&quot;ref1&quot;&gt;8&lt;/reflink&gt;]). A complex mix of genetic vulnerability and exposure to environmental adversity during the perinatal period and early childhood causes ADHD ([&lt;reflink idref=&quot;bib31&quot; id=&quot;ref2&quot;&gt;31&lt;/reflink&gt;]). For example, there is evidence that infections and inflammatory responses signaled by fever among pregnant women may act as environmental adversity to increase the risk of developing ADHD in their offspring ([&lt;reflink idref=&quot;bib13&quot; id=&quot;ref3&quot;&gt;13&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib35&quot; id=&quot;ref4&quot;&gt;35&lt;/reflink&gt;]). In addition, the developmental stage of the fetus, characteristics of the infection recurrence, or other perinatal risks associated with maternal illness may contribute to ADHD etiology ([&lt;reflink idref=&quot;bib30&quot; id=&quot;ref5&quot;&gt;30&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib35&quot; id=&quot;ref6&quot;&gt;35&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;A broad literature shows the association between infectious disorders and ADHD ([&lt;reflink idref=&quot;bib18&quot; id=&quot;ref7&quot;&gt;18&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib21&quot; id=&quot;ref8&quot;&gt;21&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib34&quot; id=&quot;ref9&quot;&gt;34&lt;/reflink&gt;]). Shigellosis ([&lt;reflink idref=&quot;bib20&quot; id=&quot;ref10&quot;&gt;20&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib28&quot; id=&quot;ref11&quot;&gt;28&lt;/reflink&gt;]), upper respiratory infections, lower respiratory infections, and pneumonia have been found at higher rates among people with ADHD ([&lt;reflink idref=&quot;bib18&quot; id=&quot;ref12&quot;&gt;18&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib22&quot; id=&quot;ref13&quot;&gt;22&lt;/reflink&gt;]). Converging evidence during the COVID-19 pandemic showed that individuals with ADHD at all ages were more vulnerable to COVID-19 infection and its adversities ([&lt;reflink idref=&quot;bib14&quot; id=&quot;ref14&quot;&gt;14&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib34&quot; id=&quot;ref15&quot;&gt;34&lt;/reflink&gt;]). They were more likely to develop COVID infection ([&lt;reflink idref=&quot;bib3&quot; id=&quot;ref16&quot;&gt;3&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib14&quot; id=&quot;ref17&quot;&gt;14&lt;/reflink&gt;]), to be symptomatic ([&lt;reflink idref=&quot;bib34&quot; id=&quot;ref18&quot;&gt;34&lt;/reflink&gt;]), and to encounter long COVID-19 ([&lt;reflink idref=&quot;bib18&quot; id=&quot;ref19&quot;&gt;18&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib23&quot; id=&quot;ref20&quot;&gt;23&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib22&quot; id=&quot;ref21&quot;&gt;22&lt;/reflink&gt;]). A recent study documented that bacterial, viral, fungal, and parasitic infections were much more prevalent among children with ADHD ([&lt;reflink idref=&quot;bib21&quot; id=&quot;ref22&quot;&gt;21&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Fever is a temporary rise in body temperature as an endocrine and autonomic response to illness or pathogens ([&lt;reflink idref=&quot;bib7&quot; id=&quot;ref23&quot;&gt;7&lt;/reflink&gt;]). The process begins with synthesizing prostaglandins, specialized lipid compounds (eicosanoids) synthesized at infection or tissue damage ([&lt;reflink idref=&quot;bib26&quot; id=&quot;ref24&quot;&gt;26&lt;/reflink&gt;]). They are hormone signalers that activate intracellular signaling and gene transcription, inducing inflammation through direct effects on the vasculature and indirect effects on inflammatory actors, such as cytokines and tumor necrosis factor ([&lt;reflink idref=&quot;bib26&quot; id=&quot;ref25&quot;&gt;26&lt;/reflink&gt;]). Among the various prostaglandins, cyclooxygenase-dependent prostaglandin E2 (PGE2) is linked explicitly to fever ([&lt;reflink idref=&quot;bib1&quot; id=&quot;ref26&quot;&gt;1&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib26&quot; id=&quot;ref27&quot;&gt;26&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib29&quot; id=&quot;ref28&quot;&gt;29&lt;/reflink&gt;]). PGE2 triggers the hypothalamus to initiate autonomic, endocrine, and behavioral processes that lead to the febrile response ([&lt;reflink idref=&quot;bib1&quot; id=&quot;ref29&quot;&gt;1&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib26&quot; id=&quot;ref30&quot;&gt;26&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib29&quot; id=&quot;ref31&quot;&gt;29&lt;/reflink&gt;]). In this way, fever is an excellent proxy for inflammatory processes initiated in response to infection, which has systemic vascular effects and indirect consequences on the brain.&lt;/p&gt; &lt;p&gt;Fever is also one of the most common reasons for consultation in pediatric practice ([&lt;reflink idref=&quot;bib9&quot; id=&quot;ref32&quot;&gt;9&lt;/reflink&gt;]). However, no diagnostic studies are routinely performed in clinical practice when clinical judgment dictates that the fever is not caused by a pathogen requiring specific diagnosis, treatment, or public health reporting (such as COVID-19). While it may be clinically relevant that some youths are more often subject to illness than others, most children are not referred for immunological evaluations. Most youths recover from episodes of fever without developing severe neuropsychiatric syndromes (e.g., Pediatric Acute-onset Neuropsychiatric Syndrome [PANS] or Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections [PANDAS]). However, no study has examined the possibility of more subtle, long-term, or cumulative associations of common infectious processes. Thus, the main aim of the present study was to evaluate whether pediatric ADHD is associated with the number and severity of febrile episodes experienced up to age 4 years, as such data could have important clinical, scientific, and public health implications.&lt;/p&gt; &lt;hd id=&quot;AN0175968762-3&quot;&gt;Objective&lt;/hd&gt; &lt;p&gt;The study objective was to examine the association of the level of fever and the number of days of fever in the first 4 years of life with subsequent diagnoses of ADHD among youth ages 5 to 18 years.&lt;/p&gt; &lt;hd id=&quot;AN0175968762-4&quot;&gt;Methods&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0175968762-5&quot;&gt;Study Design&lt;/hd&gt; &lt;p&gt;We conducted a population-based case-control study of ADHD-diagnosed children in a large Health Maintenance Organization (HMO) in Israel, Leumit Health Services (LHS), serving 724,129 persons during the study period. LHS has a comprehensive computerized database, continuously updated concerning subjects&#39; demographics, medical visits, laboratory tests, hospitalizations, and medication prescriptions. In addition, prescription records are available from 1998 and include those refilled and purchased per patient. Thus, all LHS members have similar general health insurance and equal access to health services.&lt;/p&gt; &lt;hd id=&quot;AN0175968762-6&quot;&gt;Study Population and Definitions&lt;/hd&gt; &lt;p&gt;The study population consisted of all LHS enrollees (aged 5–18 years) who were enrolled with LHS between January 1, 2002, and November 30, 2022. Cases were defined as individuals with an established diagnosis of ADHD based on ICD-9/10 (314.00–314.9). The control group included randomly selected subjects from the same group in a ratio of 2:1. Controls were matched individually by age, gender, birth year and quarter, socioeconomic status (SES) category, ethnicity, region, and cumulated years of LHS membership to the index date. They were required to have no diagnoses of ADHD.&lt;/p&gt; &lt;p&gt;ADHD was diagnosed according to the Israeli Ministry of Health criteria, following the international evaluation requirements. In addition, the diagnosing physician must be a senior physician specializing in the ADHD field (child or adult psychiatrists, child or adult neurologists, pediatricians, and family physicians with certified ADHD training).&lt;/p&gt; &lt;p&gt;SES has been applied from the Israeli Central Bureau of Statistics classification system, which includes 20 sub-groups delineated according to patients&#39; home addresses. Classifications one to three were considered very low SES, four to six—low, seven to nine—medium, and 10 to 20 were considered medium-high SES.&lt;/p&gt; &lt;p&gt;Strictly matching the control group to the cases by relevant variables (age, gender, ethnicity, region, and SES) allows a reduction of the probability of confounding.&lt;/p&gt; &lt;hd id=&quot;AN0175968762-7&quot;&gt;Classification of Exposure&lt;/hd&gt; &lt;p&gt;The range of recorded body temperature and the number of days with fever measurements defined the exposures.&lt;/p&gt; &lt;p&gt;Febrile episodes were obtained from the EMR for each participant during the first 4 years of life. We used body temperature measurements performed in the clinic and considered five thresholds of body temperature: 37.5&#176;C, 38&#176;C, 38.5&#176;C, 39&#176;C, and ≥39.5&#176;C. For each participant and each threshold, we calculated the number of distinct dates at which a temperature measurement above the threshold was recorded during the first 4 years of life and categorized this number as 0, 1, 2, or greater or equal to 3. We then compare the number and intensity of febrile episodes between the two groups during the first 4 years.&lt;/p&gt; &lt;hd id=&quot;AN0175968762-8&quot;&gt;Statistical Analysis&lt;/hd&gt; &lt;p&gt;Statistical analysis was performed using R-statistics software. All tests were two-sided with an α of &amp;lt;.05. Socio-demographic characteristics between the ADHD and non-ADHD control groups were compared using the &lt;emph&gt;t&lt;/emph&gt;-test and Fisher exact test for continuous and categorical variables, respectively. The association between the outcome (probability of being diagnosed with ADHD) and exposures was evaluated using logistic regression analysis; odds ratios (OR) and 95% confidence interval (CI) were calculated.&lt;/p&gt; &lt;p&gt;The Institutional Review Board of the LHS approved the study protocol (authorization number LEU-0005-22).&lt;/p&gt; &lt;hd id=&quot;AN0175968762-9&quot;&gt;Results&lt;/hd&gt; &lt;p&gt;Figure 1 shows the cohort creation procedure. 204,871 children aged between 5 and 17 were identifed out of 724,129 LHS active members as of November 2011. In this population, 18,558 children with a diagnosis of ADHD were matched with a control group of 37,116 children not diagnosed with ADHD (1:2 ratio). The socio-demographic characteristics of the study groups are presented in Table 1. All variables, including mean age, distribution of age categories, gender, ethnic sector, region of residence, and SES, were very similar between the ADHD and control groups, with no statistically significant differences.&lt;/p&gt; &lt;p&gt;Graph: Figure 1. Study flowchart. Note. LHS = Leumit Health Services; ADHD = attention-deficit/hyperactivity disorder; SES = socioeconomic status; SD = standard deviation.Missing Data: SES data was missing among 11.46% of cases and 11.44% of controls.&lt;/p&gt; &lt;p&gt;Graph&lt;/p&gt; &lt;p&gt;Table 1. Socio-demographic Characteristics of the ADHD Cases and Matched Controls.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;colgroup&amp;gt;&amp;lt;col align=&quot;left&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;/colgroup&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;th /&amp;gt;&amp;lt;th /&amp;gt;&amp;lt;th align=&quot;center&quot;&amp;gt;ADHD cases&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;center&quot;&amp;gt;Matched controls&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;center&quot;&amp;gt;OR&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;center&quot;&amp;gt;&amp;lt;italic&amp;gt;p&amp;lt;/italic&amp;gt;-Value&amp;lt;/th&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;N&amp;lt;/italic&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;18,558&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;37,116&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td rowspan=&quot;4&quot;&amp;gt;Region&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;South&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4,355 (23.5%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;8,710 (23.5%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Jerusalem&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6,909 (37.2%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;13,818 (37.2%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Center&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4,717 (25.4%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;9,434 (25.4%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;North&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2,577 (13.9%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;5,154 (13.9%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Age, mean, &amp;lt;italic&amp;gt;SD&amp;lt;/italic&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;8.38 (2.71)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;8.38 (2.71)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.979&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Female gender&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;True&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6,781 (36.5%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;13,562 (36.5%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Ethnicity&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;General&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;10,267 (55.3%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;20,534 (55.3%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;Arab&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1,640 (8.8%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3,280 (8.8%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;Jewish ultra-orthodox&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6,651 (35.8%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;13,302 (35.8%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td rowspan=&quot;2&quot;&amp;gt;SES level, mean, &amp;lt;italic&amp;gt;SD&amp;lt;/italic&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;7.92 (3.94)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;7.92 (3.98)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.928&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Missing data&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2,126 (11.46%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4,236 (11.41%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td rowspan=&quot;5&quot;&amp;gt;SES categories&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Very-low&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2,717 (14.6%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;5,434 (14.6%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Low&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3,988 (21.5%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;7,976 (21.5%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Medium&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3,227 (17.4%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6,454 (17.4%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Medium-high&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6,498 (35.0%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;12,996 (35.0%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Missing data&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2,128 (11.5%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4,256 (11.5%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;1 &lt;emph&gt;Note.&lt;/emph&gt; ADHD = attention deficit and hyperactivity/impulsivity disorder; SES = socio-economic status.&lt;/p&gt; &lt;p&gt;During their first 4 years of life, children of the ADHD group had significantly more febrile episodes than those without ADHD (&lt;emph&gt;p&lt;/emph&gt; &amp;lt;.001 for each of the thresholds 37.5&#176;C, 38&#176;C, 38.5&#176;C, 39&#176;C). In contrast, when we looked at zero episodes of fever, all the ORs were below 1, indicating that no recorded fever episode was associated with a significantly reduced rate of future ADHD. Fever severity and the number of days of fever played a significant role, demonstrating a significant dose-response association (Figure 2). Notably, we observed a fever &amp;gt;39.5&#176;C for ≥ 3 days associated with ADHD with OR = 2.135 (1.256–3.639; &lt;emph&gt;p&lt;/emph&gt; =.0029).&lt;/p&gt; &lt;p&gt;Graph: Figure 2. Dose-response association between magnitude and number of febrile measurements and ADHD. Note. ADHD = attention-deficit/hyperactivity disorder.&lt;/p&gt; &lt;hd id=&quot;AN0175968762-10&quot;&gt;Discussion&lt;/hd&gt; &lt;p&gt;This observational database study investigated the associations between episodes of fever recorded in the clinic during the first 4 years of life and the diagnosis of ADHD later in youth. There was a clinically significant association between the number of febrile episodes and the degree of elevation of the body temperature during these episodes and subsequent diagnosis of ADHD. The mechanisms underpinning these associations are yet to be delineated. Fever in children under four is usually caused by inflammation as a response to viral, bacterial, or parasitic infections. However, this inflammatory reaction can also be caused by noninfectious factors such as immune dysregulation and allergies.&lt;/p&gt; &lt;p&gt;Infancy and early childhood are humans&#39; most dynamic and important phases of postnatal brain development. There is a considerable increase in gray matter volume ([&lt;reflink idref=&quot;bib19&quot; id=&quot;ref33&quot;&gt;19&lt;/reflink&gt;]) and overall brain size during this period, reaching 80% to 90% of the adult volume by the age of 2 years ([&lt;reflink idref=&quot;bib25&quot; id=&quot;ref34&quot;&gt;25&lt;/reflink&gt;]). In addition, new synapses ([&lt;reflink idref=&quot;bib12&quot; id=&quot;ref35&quot;&gt;12&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib15&quot; id=&quot;ref36&quot;&gt;15&lt;/reflink&gt;]) and myelination of white matter develop rapidly after birth and reach adult levels of myelination by the age of 2 years ([&lt;reflink idref=&quot;bib5&quot; id=&quot;ref37&quot;&gt;5&lt;/reflink&gt;]). Concurrent with the rapid pace of structural brain development is the rapid development of a wide range of cognitive functions. Therefore, acute distress to the central nervous system during this critical period may lead to varied neurobehavioral outcomes.&lt;/p&gt; &lt;p&gt;A nationwide study in Denmark confirmed an association between bacterial/viral infections and subsequent risk for a variety of mental disorders in children and adolescents ([&lt;reflink idref=&quot;bib17&quot; id=&quot;ref38&quot;&gt;17&lt;/reflink&gt;]). Febrile episodes might contribute to the development of ADHD by two central mechanisms: direct effects of the infectious agent or the immune system components on the brain or more generalized and indirect effects of systemic inflammation. We have previously shown that shigellosis during the first 3 years of life is significantly associated with increased rates of ADHD ([&lt;reflink idref=&quot;bib20&quot; id=&quot;ref39&quot;&gt;20&lt;/reflink&gt;]). The Shigella pathogen or immune components (e.g., cytokines or lymphocytes) might be directly responsible for the association. However, this pathogen can cause seizures during its acute phase, and seizure activity can indirectly mediate brain outcomes. A mouse model of shigellosis further demonstrated that systemic and brain inflammation develops due to shigellosis ([&lt;reflink idref=&quot;bib37&quot; id=&quot;ref40&quot;&gt;37&lt;/reflink&gt;]). Fever-associated prostaglandins mediate this inflammation and might contribute more generally to neurodevelopmental impairments. It is also possible that fever, either itself or as a feature of inflammation, interferes with normal brain development during critical periods in early childhood. Increasing evidence shows that the central nervous system is particularly vulnerable to hyperthermia ([&lt;reflink idref=&quot;bib33&quot; id=&quot;ref41&quot;&gt;33&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Inflammation itself may be a trigger of adverse neurodevelopmental processes through epigenetic shared vulnerabilities ([&lt;reflink idref=&quot;bib16&quot; id=&quot;ref42&quot;&gt;16&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib24&quot; id=&quot;ref43&quot;&gt;24&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib32&quot; id=&quot;ref44&quot;&gt;32&lt;/reflink&gt;]). Immune-genetic processes may be more vulnerable to being triggered by an underlying inflammation or the fever itself ([&lt;reflink idref=&quot;bib10&quot; id=&quot;ref45&quot;&gt;10&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib27&quot; id=&quot;ref46&quot;&gt;27&lt;/reflink&gt;]). Thus, certain inherited immune predispositions may cause an interaction between the nervous and immune systems, resulting in a specific disorder ([&lt;reflink idref=&quot;bib2&quot; id=&quot;ref47&quot;&gt;2&lt;/reflink&gt;]). One small study by [&lt;reflink idref=&quot;bib4&quot; id=&quot;ref48&quot;&gt;4&lt;/reflink&gt;] demonstrated that early childhood infection was significantly associated with several psychiatric disorders, including ADHD, unexplained by genetic confounding. It is also possible that the fever, either itself or as a feature of the inflammation, interferes with normal brain development during critical periods in early childhood. Increasing evidence shows that the central nervous system is particularly vulnerable to hyperthermia ([&lt;reflink idref=&quot;bib33&quot; id=&quot;ref49&quot;&gt;33&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Several authors propose a direct connection between neuroinflammation and increased risk for ADHD ([&lt;reflink idref=&quot;bib6&quot; id=&quot;ref50&quot;&gt;6&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib36&quot; id=&quot;ref51&quot;&gt;36&lt;/reflink&gt;]). For example, [&lt;reflink idref=&quot;bib36&quot; id=&quot;ref52&quot;&gt;36&lt;/reflink&gt;] describe how periodontitis, a bacterial infection, triggers a neuroinflammatory systemic response involving elevated TNF-α, IL-6, IL-7, and white blood cells that activate microglial cells. The authors propose that this inflammation may contribute to ADHD pathophysiology ([&lt;reflink idref=&quot;bib36&quot; id=&quot;ref53&quot;&gt;36&lt;/reflink&gt;]). The microglia, they theorize, may directly damage dopamine neurons or may release reactive oxygen species molecules (ROS) and nitrogen oxides (NO) that indirectly damage dopaminergic neurons, changing dopaminergic neurotransmission and exacerbating ADHD symptoms ([&lt;reflink idref=&quot;bib36&quot; id=&quot;ref54&quot;&gt;36&lt;/reflink&gt;]). Another example is systemic lupus erythematosus patients, who exhibit high levels of ADHD symptoms that responded to N-acetylcysteine, which has some anti-inflammatory and antioxidant properties ([&lt;reflink idref=&quot;bib11&quot; id=&quot;ref55&quot;&gt;11&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;The present study supports this prior literature by documenting a robust dose-response association between fever magnitude (measured by temperature level) and frequency (measured by the number of days of fever) and later diagnoses of ADHD. However, the study methodology cannot reveal the pathophysiology underpinning this finding. Elevated body temperature, either itself or as an attribute of inflammatory processes in infancy and early childhood, may play a role in the emergence of ADHD.&lt;/p&gt; &lt;hd id=&quot;AN0175968762-11&quot;&gt;Strengths and Limitations&lt;/hd&gt; &lt;p&gt;This study has several strengths. The strict matching between cases and controls ensured that differences between the two groups were due to the exposure being studied (fever severity and frequency) and not to age, sex, or socioeconomic status. Using a nationwide population-based design also helps to enhance the generalizability of the findings.&lt;/p&gt; &lt;p&gt;Furthermore, the study was conducted within the same health insurance system, providing a consistent medical care and diagnosis framework reducing potential variation in clinical practices and diagnostic criteria. The large sample size also enabled statistical power, making it possible to detect significant differences between the study groups.&lt;/p&gt; &lt;p&gt;Several limitations to this study should be considered. As an observational study, the design can only identify associations between events and cannot establish causality. It is possible that unmeasured confounding accounts for some or all of the observed association. Additionally, the study was conducted in a single Israeli HMO population and may not represent ethnic heterogeneity.&lt;/p&gt; &lt;p&gt;Only fever measurements taken during physical examinations in outpatient clinics were recorded in the EMR and included in the analysis, potentially limiting the data available. It is also possible that there were behavioral differences among parents, particularly between those of children with and without ADHD, which could have affected the results. Our previous study found that parents of children with ADHD tend to visit healthcare centers more often than families of youth without these diagnoses ([&lt;reflink idref=&quot;bib21&quot; id=&quot;ref56&quot;&gt;21&lt;/reflink&gt;]). There is a possibility that the fever was measured outside of the clinic and was not recorded in the electronic medical file, which would have impacted the number of recorded febrile episodes. However, the parent&#39;s behavior is unlikely to affect the level of the measured fever. Therefore, the validity of the observed association between the level of fever measurements and ADHD seems robust.&lt;/p&gt; &lt;hd id=&quot;AN0175968762-12&quot;&gt;Conclusions&lt;/hd&gt; &lt;p&gt;The present study found a significant association between the number and intensity of febrile measurements in the first 4 years of life and subsequent diagnosis of ADHD. Physicians should be aware of these associations. Although speculative, repeated exposures to febrile episodes may contribute, in a dose-dependent manner, to a disruption in neurodevelopmental pathways implicated in the emergence of ADHD. Further prospective studies are required to determine causality and elucidate plausible pathophysiological mechanisms.&lt;/p&gt; &lt;p&gt;This paper is dedicated to Joe Biederman, one of the writers at the beginning of this study. Sadly, his contribution to this work was short but inspirational, essential, and had a lot of impact. This study continues a former study, the association between ADHD and childhood infections (Merzon E et al., doi: 10.1016/j.jaac.2022.06.018), in which he was one of the principal authors. This line of work demonstrates our shared belief that ADHD is a medical problem, a view that drove us to enter 21st-century psychiatry. He was the mentor of Prof. Faraone and Prof. Manor, and is an inspiration to us all; his unique supervision will not be forgotten.&lt;/p&gt; &lt;ref id=&quot;AN0175968762-13&quot;&gt; &lt;title&gt; Footnotes &lt;/title&gt; &lt;blist&gt; &lt;bibl id=&quot;bib1&quot; idref=&quot;ref26&quot; type=&quot;bt&quot;&gt;1&lt;/bibl&gt; &lt;bibtext&gt; Abraham Weizman and Iris Manor are also affiliated to Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib2&quot; idref=&quot;ref47&quot; type=&quot;bt&quot;&gt;2&lt;/bibl&gt; &lt;bibtext&gt; The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Over the past 3 years, Dr. Eugene Merzon received support for continuing medical education programs or advisory board meetings sponsored by SK-Pharma, Medison Israel, Teva Israel, AstraZeneca Israel, and Merk Israel. Over the past 3 years, Dr. Ariel Israel has had No disclosure Dr. Beth Krone: Over the past 3 years, Dr. Krone has received financial compensation as a scientific consultant to HIPPO T &amp;amp; C and MaxisHealth, makers of digital health technologies for ADHD. Dr. Krone also provides clinical reviews for Signant Health, which provides rater training for clinical trials. Over the past 3 years, Ms. Shira Cohen has made no disclosure. Over the past 3 years, Dr. Ilan Green has no disclosure Over the past 3 years, Dr. Avivit Golan-Cohen has no disclosure Over the past 3 years, Prof. Shlomo Vinker has no disclosure Over the past 3 years, Dr. Faraone received income, potential income, travel expenses, continuing education support and research support from Aardvark, Aardwolf, AIMH, Tris, Otsuka, Ironshore, Kanjo, Johnson &amp;amp; Johnson/Kenvue, KemPharm/Corium, Akili, Supernus, Atentiv, Noven, Sky Therapeutics, Axsome and Genomind, Shire/Takeda, Arbor, Medice, Ondosis, Rhodes, and Vallon. He has a U.S. patent, US20130217707 A1, with his institution for using sodium-hydrogen exchange inhibitors to treat ADHD. He also receives royalties from books published by Guilford Press: Straight Talk about Your Child&#39;s Mental Health; Oxford University Press: Schizophrenia: The Facts; and Elsevier: ADHD: Non-Pharmacologic Interventions. He is the Program Director of &lt;ulink href=&quot;http://www.ADHDEvidence.org&quot;&gt;http://www.ADHDEvidence.org&lt;/ulink&gt; and &lt;ulink href=&quot;http://www.ADHDinAdults.com&quot;&gt;http://www.ADHDinAdults.com&lt;/ulink&gt;. Dr. Faraone is supported by the European Union&#39;s Horizon 2020 research and innovation program under grant agreement No 965381; NIMH grants U01AR076092-01A1, 1R21MH1264940, R01MH116037; 1R01NS128535 – 01; Oregon Health and Science University, Otsuka Pharmaceuticals, Noven Pharmaceuticals Incorporated, and Supernus Pharmaceutical Company. Over the past 3 years, Prof. Jeff Newcorn has received financial compensation as a consultant, advisory board member, and lecturer from Shire Pharmaceuticals (the study sponsor and manufacturer of the study drug Vyvanse [Lisdexamfetamine]). Dr. Newcorn also receives financial compensation from other companies that either develop or assess medicines used for treating ADHD. Prof. Shai Ashkenazi has not disclosed relevant to this manuscript over the past 3 years. Prof. Eli Magen has not disclosed relevant to this manuscript over the past 3 years. Over the past 3 years, Prof Abraham Weizman has declared honoraria for educational lectures from the following pharmaceutical companies: Pfizer, Novartis, Janssen, Lundbeck, Teva, Unipharm, Dexcel, and Medison. None of these are relevant to the submitted manuscript. Over the past 3 years, Prof. Iris Manor has received financial compensation as a consultant, advisory board member, and lecturer from Madison Ltd. (the distributor of the study drug Vyvance (Lisdexamfetamine) in Israel) and Teva Israel (the manufacturer and the distributor in Israel of the study drug attent (Mixed Amphetamine Salts), and attent X.R. (Mixed Amphetamine Salts-Extended Release). She was a lecturer for Takeda Ltd. Dr. Manor is a consultant to the startup companies Peri and Vizo, which either develop or assess medicines used to treat ADHD. She also served/serves as a P.I. (as a part of her position in Geha MHC) in several startups: Nuance Ltd and Mindtension Ltd.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib3&quot; idref=&quot;ref16&quot; type=&quot;bt&quot;&gt;3&lt;/bibl&gt; &lt;bibtext&gt; The author(s) received no financial support for the research, authorship, and/or publication of this article.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib4&quot; idref=&quot;ref48&quot; type=&quot;bt&quot;&gt;4&lt;/bibl&gt; &lt;bibtext&gt; Eugene Merzon&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;Graph&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;https://orcid.org/0000-0001-5469-0236 Beth Krone&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;Graph&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;https://orcid.org/0000-0003-4046-8305 Abraham Weizman&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib5&quot; idref=&quot;ref37&quot; type=&quot;bt&quot;&gt;&lt;/bibl&gt; &lt;bibtext&gt;Graph&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib6&quot; idref=&quot;ref50&quot; type=&quot;bt&quot;&gt;&lt;/bibl&gt; &lt;bibtext&gt;https://orcid.org/0000-0002-9765-8938 Iris Manor&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib7&quot; idref=&quot;ref23&quot; type=&quot;bt&quot;&gt;&lt;/bibl&gt; &lt;bibtext&gt;Graph https://orcid.org/0000-0002-0642-0028&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; * Dr. Ariel Israel and Dr. Eugene Merzon are co-first authors who collaborated on the publication and contributed equally.&lt;/bibtext&gt; &lt;/blist&gt; &lt;/ref&gt; &lt;ref id=&quot;AN0175968762-14&quot;&gt; &lt;title&gt; References &lt;/title&gt; &lt;blist&gt; &lt;bibtext&gt; Biddle C. (2006). The neurobiology of the human febrile response. AANA Journal, 74(2), 145–150.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Chen Y., Dai J., Tang L., Mikhailova T., Liang Q., Li M., Zhou J., Kopp R. F., Weickert C., Chen C., Liu C. (2023). Neuroimmune transcriptome changes in patient brains of psychiatric and neurological disorders. Molecular Psychiatry, 28(2), 710–721.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Cohen H. A., Gerstein M., Yaniv N., Richenberg Y., Jacobson E., Marton S., Hoshen M., Shkalim Zemer V. (2022). Attention-Deficit/hyperactivity disorder as a risk factor for COVID-19 infection. Journal of Attention Disorders, 26(7), 985–990.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Debost J. P. G., Thorsteinsson E., Trabjerg B., Benros M. E., Albi&#241;ana C., Vilhjalmsson B. J., B&#248;rglum A., Mors O., Werge T., Mortensen P. B., Agerbo E., Petersen L. V. (2022). Genetic and psychosocial influence on the association between early childhood infections and later psychiatric disorders. Acta Psychiatrica Scandinavica, 146(5), 406–419.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Dubois J., Dehaene-Lambertz G., Kulikova S., Poupon C., H&#252;ppi P. S., Hertz-Pannier L. (2014). The early development of brain white matter: A review of imaging studies in fetuses, newborns and infants. Neuroscience, 276, 48–71.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Dunn G. A., Nigg J. T., Sullivan E. L. (2019). Neuroinflammation as a risk factor for attention deficit hyperactivity disorder. Pharmacology, Biochemistry, and Behavior, 182, 22–34.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Evans S. S., Repasky E. A., Fisher D. T. (2015). Fever and the thermal regulation of immunity: The immune system feels the heat. Nature Reviews. Immunology, 15(6), 335–349.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib8&quot; idref=&quot;ref1&quot; type=&quot;bt&quot;&gt;8&lt;/bibl&gt; &lt;bibtext&gt; Faraone S. V., Banaschewski T., Coghill D., Zheng Y., Biederman J., Bellgrove M. A., Newcorn J. H., Gignac M., Al Saud N. M., Manor I., Rohde L. A., Yang L., Cortese S., Almagor D., Stein M. A., Albatti T. H., Aljoudi H. F., Alqahtani M. M. J., Asherson P.,,.. Wang Y. (2021). The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Neuroscience and Biobehavioral Reviews, 128, 789–818.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib9&quot; idref=&quot;ref32&quot; type=&quot;bt&quot;&gt;9&lt;/bibl&gt; &lt;bibtext&gt; Finley C. R., Chan D. S., Garrison S., Korownyk C., Kolber M. R., Campbell S., Eurich D. T., Lindblad A. J., Vandermeer B., Allan G. M. (2018). What are the most common conditions in primary care? Systematic review. Canadian Family Physician Medecin de Famille Canadien, 64(11), 832–840.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Garcia-Argibay M., du Rietz E., Lu Y., Martin J., Haan E., Lehto K., Bergen S. E., Lichtenstein P., Larsson H., Brikell I. (2022). Correction: The role of ADHD genetic risk in mid-to-late life somatic health conditions. Translational Psychiatry, 12(1), 166.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Garcia R. J., Francis L., Dawood M., Lai Z. W., Faraone S. V., Perl A. (2013). Attention deficit and hyperactivity disorder scores are elevated and respond to N-acetylcysteine treatment in patients with systemic lupus erythematosus. Arthritis and Rheumatism, 65(5), 1313–1318.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Glantz L. A., Gilmore J. H., Hamer R. M., Lieberman J. A., Jarskog L. F. (2007). Synaptophysin and postsynaptic density protein 95 in the human prefrontal cortex from mid-gestation into early adulthood. Neuroscience, 149(3), 582–591.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Gustavson K., Ask H., Ystrom E., Stoltenberg C., Lipkin W. I., Sur&#233;n P., H&#229;berg S. E., Magnus P., Knudsen G. P., Eilertsen E., Bresnahan M., Aase H., Mjaaland S., Susser E. S., Hornig M., Reichborn-Kjennerud T. (2019). Maternal fever during pregnancy and offspring attention deficit hyperactivity disorder. Scientific Reports, 9(1), 9519.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Heslin K. P., Haruna A., George R. A., Chen S., Nobel I., Anderson K. B., Faraone S. V., Zhang-James Y. (2023). Association between ADHD and COVID-19 infection and clinical outcomes: A Retrospective Cohort Study from Electronic Medical Records. Journal of Attention Disorders, 27(2), 169–181.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Huttenlocher P. R., Dabholkar A. S. (1997). Regional differences in synaptogenesis in human cerebral cortex. The Journal of Comparative Neurology, 387(2), 167–178.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Jiang P. P., Peng S. S., Pankratova S., Luo P., Zhou P., Chen Y. (2022). Proteins involved in synaptic plasticity are downregulated in the cerebrospinal fluid of infants with clinical sepsis complicated by neuroinflammation. Frontiers in Cellular Neuroscience, 16.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; K&#246;hler-Forsberg O., Petersen L., Gasse C., Mortensen P. B., Dalsgaard S., Yolken R. H., Mors O., Benros M. E. (2019). A nationwide study in Denmark of the association between treated infections and the subsequent risk of treated mental disorders in children and adolescents. JAMA Psychiatry, 76(3), 271–279.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Li D. J., Chen Y. L., Hsiao R. C., Chen H. L., Yen C. F. (2021). Risk of respiratory infectious diseases and the role of methylphenidate in children with attention-deficit/hyperactivity disorder: A population-based cohort study. International Journal of Environmental Research and Public Health, 18(11), 5824.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Matsuzawa J., Matsui M., Konishi T., Noguchi K., Gur R. C., Bilker W., Miyawaki T. (2001). Age-related volumetric changes of brain gray and white matter in healthy infants and children. Cerebral Cortex, 11(4), 335–342.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Merzon E., Gutbir Y., Vinker S., Golan Cohen A., Horwitz D., Ashkenazi S., Sadaka Y. (2021). Early childhood shigellosis and attention deficit hyperactivity disorder: A population-based cohort study with a prolonged follow-up. Journal of Attention Disorders, 25(13), 1791–1800.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Merzon E., Israel A., Ashkenazi S., Rotem A., Schneider T., Faraone S. V., Biederman J., Green I., Golan-Cohen A., Vinker S., Weizman A., Manor I. (2023). Attention-deficit/hyperactivity disorder is associated with increased rates of childhood infectious diseases: A population-based case-control study. Journal of the American Academy of Child and Adolescent Psychiatry, 62(2), 253–260.e1.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Merzon E., Manor I., Rotem A., Schneider T., Vinker S., Golan Cohen A., Lauden A., Weizman A., Green I. (2021). ADHD as a risk factor for infection with Covid-19. Journal of Attention Disorders, 25(13), 1783–1790.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Merzon E., Weiss M., Krone B., Cohen S., Ilani G., Vinker S., Cohen-Golan A., Green I., Israel A., Schneider T., Ashkenazi S., Weizman A., Manor I. (2022). Clinical and socio-demographic variables associated with the diagnosis of Long COVID syndrome in youth: A population-based study. International Journal of Environmental Research and Public Health, 19(10), 5993.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Meszaros Z. S., Perl A., Faraone S. V. (2012). Psychiatric symptoms in systemic lupus erythematosus: A systematic review. The Journal of Clinical Psychiatry, 73(7), 993–1001.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Pfefferbaum A., Mathalon D. H., Sullivan E. V., Rawles J. M., Zipursky R. B., Lim K. O. (1994). A quantitative magnetic resonance imaging study of changes in brain morphology from infancy to late adulthood. Archives of Neurology, 51(9), 874–887.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Ricciotti E., FitzGerald G. A. (2011). Prostaglandins and inflammation. Arteriosclerosis, Thrombosis, and Vascular Biology, 31(5), 986–1000.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Ryan J. G., Kastner D. L. (2008). Fevers, genes, and innate immunity. Current Topics in Microbiology and Immunology, 321, 169–184.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Sadaka Y., Freedman J., Ashkenazi S., Vinker S., Golan-Cohen A., Green I., Israel A., Eran A., Merzon E. (2021). The effect of antibiotic treatment of early childhood shigellosis on long-term prevalence of attention deficit/hyperactivity disorder. Children, 8(10), 880.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Saper C. B. (1998). Neurobiological basis of fever. Annals of the New York Academy of Sciences, 856(1), 90–94.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Sucksdorff M., Lehtonen L., Chudal R., Suominen A., Gissler M., Sourander A. (2018). Lower Apgar scores and caesarean sections are related to attention-deficit/hyperactivity disorder. Acta Paediatrica, 107(10), 1750–1758.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Thapar A., Cooper M., Eyre O., Langley K. (2013). What have we learnt about the causes of ADHD? Journal of Child Psychology and Psychiatry, and Allied Disciplines, 54(1), 3–16.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Tylee D. S., Sun J., Hess J. L., Tahir M. A., Sharma E., Malik R., Worrall B. B., Levine A. J., Martinson J. J., Nejentsev S., Speed D., Fischer A., Mick E., Walker B. R., Crawford A., Grant S. F. A., Polychronakos C., Bradfield J. P., Sleiman P. M. A.,,.. Glatt S. J. (2018). Genetic correlations among psychiatric and immune-related phenotypes based on genome-wide association data. American Journal of Medical Genetics. Part B, Neuropsychiatric genetics, 177(7), 641–657.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Walter E. J., Carraretto M. (2016). The neurological and cognitive consequences of hyperthermia. Critical Care, 20(1), 199.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Wang Q., Xu R., Volkow N. D. (2021). Increased risk of COVID-19 infection and mortality in people with mental disorders: Analysis from electronic health records in the United States. World Psychiatry, 20(1), 124–130.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Werenberg Dreier J., Nybo Andersen A. M., Hvolby A., Garne E., Kragh Andersen P., Berg-Beckhoff G. (2016). Fever and infections in pregnancy and risk of attention deficit/hyperactivity disorder in the offspring. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 57(4), 540–548.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Wilson S. K., Thomas J. (2022). Peridontitis as a risk factor for attention deficit hyperactivity disorder: Possible neuro-inflammatory mechanisms. Neurochemical Research, 47(10), 2925–2935.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Yuhas Y., Weizman A., Ashkenazi S. (2003). Bidirectional concentration-dependent effects of tumor necrosis factor alpha in Shigella dysenteriae-related seizures. Infection and Immunity, 71(4), 2288–2291.&lt;/bibtext&gt; &lt;/blist&gt; &lt;/ref&gt; &lt;aug&gt; &lt;p&gt;By Ariel Israel; Eugene Merzon; Beth Krone; Stephen V. Faraone; Ilan Green; Avivit Golan Cohen; Shlomo Vinker; Shira Cohen; Shai Ashkenazi; Eli Magen; Abraham Weizman and Iris Manor&lt;/p&gt; &lt;p&gt;Reported by Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author&lt;/p&gt; &lt;/aug&gt; &lt;nolink nlid=&quot;nl1&quot; bibid=&quot;bib31&quot; firstref=&quot;ref2&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl2&quot; bibid=&quot;bib13&quot; firstref=&quot;ref3&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl3&quot; bibid=&quot;bib35&quot; firstref=&quot;ref4&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl4&quot; bibid=&quot;bib30&quot; firstref=&quot;ref5&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl5&quot; bibid=&quot;bib18&quot; firstref=&quot;ref7&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl6&quot; bibid=&quot;bib21&quot; firstref=&quot;ref8&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl7&quot; bibid=&quot;bib34&quot; firstref=&quot;ref9&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl8&quot; bibid=&quot;bib20&quot; firstref=&quot;ref10&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl9&quot; bibid=&quot;bib28&quot; firstref=&quot;ref11&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl10&quot; bibid=&quot;bib22&quot; firstref=&quot;ref13&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl11&quot; bibid=&quot;bib14&quot; firstref=&quot;ref14&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl12&quot; bibid=&quot;bib23&quot; firstref=&quot;ref20&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl13&quot; bibid=&quot;bib26&quot; firstref=&quot;ref24&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl14&quot; bibid=&quot;bib29&quot; firstref=&quot;ref28&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl15&quot; bibid=&quot;bib19&quot; firstref=&quot;ref33&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl16&quot; bibid=&quot;bib25&quot; firstref=&quot;ref34&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl17&quot; bibid=&quot;bib12&quot; firstref=&quot;ref35&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl18&quot; bibid=&quot;bib15&quot; firstref=&quot;ref36&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl19&quot; bibid=&quot;bib17&quot; firstref=&quot;ref38&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl20&quot; bibid=&quot;bib37&quot; firstref=&quot;ref40&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl21&quot; bibid=&quot;bib33&quot; firstref=&quot;ref41&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl22&quot; bibid=&quot;bib16&quot; firstref=&quot;ref42&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl23&quot; bibid=&quot;bib24&quot; firstref=&quot;ref43&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl24&quot; bibid=&quot;bib32&quot; firstref=&quot;ref44&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl25&quot; bibid=&quot;bib10&quot; firstref=&quot;ref45&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl26&quot; bibid=&quot;bib27&quot; firstref=&quot;ref46&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl27&quot; bibid=&quot;bib36&quot; firstref=&quot;ref51&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl28&quot; bibid=&quot;bib11&quot; firstref=&quot;ref55&quot;&gt;&lt;/nolink&gt;
Header DbId: eric
DbLabel: ERIC
An: EJ1440635
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: The Association between Repeated Measured Febrile Episodes during Early Childhood and Attention Deficit Hyperactivity Disorder: A Large-Scale Population-Based Study
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ariel+Israel%22&quot;&gt;Ariel Israel&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Eugene+Merzon%22&quot;&gt;Eugene Merzon&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0001-5469-0236&quot;&gt;0000-0001-5469-0236&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Beth+Krone%22&quot;&gt;Beth Krone&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0003-4046-8305&quot;&gt;0000-0003-4046-8305&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Stephen+V%2E+Faraone%22&quot;&gt;Stephen V. Faraone&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ilan+Green%22&quot;&gt;Ilan Green&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Avivit+Golan+Cohen%22&quot;&gt;Avivit Golan Cohen&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Shlomo+Vinker%22&quot;&gt;Shlomo Vinker&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Shira+Cohen%22&quot;&gt;Shira Cohen&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Shai+Ashkenazi%22&quot;&gt;Shai Ashkenazi&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Eli+Magen%22&quot;&gt;Eli Magen&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Abraham+Weizman%22&quot;&gt;Abraham Weizman&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0002-9765-8938&quot;&gt;0000-0002-9765-8938&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Iris+Manor%22&quot;&gt;Iris Manor&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0002-0642-0028&quot;&gt;0000-0002-0642-0028&lt;/externalLink&gt;)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;SO&quot; term=&quot;%22Journal+of+Attention+Disorders%22&quot;&gt;&lt;i&gt;Journal of Attention Disorders&lt;/i&gt;&lt;/searchLink&gt;. 2024 28(5):677-685.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 9
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2024
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles&lt;br /&gt;Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Physiology%22&quot;&gt;Physiology&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Young+Children%22&quot;&gt;Young Children&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Incidence%22&quot;&gt;Incidence&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Attention+Deficit+Hyperactivity+Disorder%22&quot;&gt;Attention Deficit Hyperactivity Disorder&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Correlation%22&quot;&gt;Correlation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Children%22&quot;&gt;Children&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Adolescents%22&quot;&gt;Adolescents&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Probability%22&quot;&gt;Probability&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Neurology%22&quot;&gt;Neurology&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Foreign+Countries%22&quot;&gt;Foreign Countries&lt;/searchLink&gt;
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Israel%22&quot;&gt;Israel&lt;/searchLink&gt;
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1177/10870547231215289
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1087-0547&lt;br /&gt;1557-1246
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: We examined the association between the number, magnitude, and frequency of febrile episodes during the 0 to 4 years of life and subsequent diagnosis of ADHD. Methods: This population-based case-control study in an Israeli HMO, Leumit Health Services (LHS), uses a database for all LHS members aged 5 to 18 years between 1/1/2002 and 1/30/2022. The number and magnitude of measured fever episodes during the 0 to 4 years were recorded in individuals with ADHD (N = 18,558) and individually matched non-ADHD controls in a 1:2 ratio (N = 37,116). Results: A significant, independent association was found between the number and magnitude of febrile episodes during the 0 to 4 years and the probability of a later diagnosis of ADHD. Children who never had a measured temperature &gt;37.5&#176;C had a significantly lower rate of ADHD (OR = 0.834, 95% CI [0.802, 0.866], p &lt; 0.0001). Conclusions: Febrile episodes during 0 to 4 years are associated with a significantly increased rate of a later diagnosis of ADHD in a dose-response relationship.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2024
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1440635
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1440635
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1177/10870547231215289
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 9
        StartPage: 677
    Subjects:
      – SubjectFull: Physiology
        Type: general
      – SubjectFull: Young Children
        Type: general
      – SubjectFull: Incidence
        Type: general
      – SubjectFull: Attention Deficit Hyperactivity Disorder
        Type: general
      – SubjectFull: Correlation
        Type: general
      – SubjectFull: Children
        Type: general
      – SubjectFull: Adolescents
        Type: general
      – SubjectFull: Probability
        Type: general
      – SubjectFull: Neurology
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Israel
        Type: general
    Titles:
      – TitleFull: The Association between Repeated Measured Febrile Episodes during Early Childhood and Attention Deficit Hyperactivity Disorder: A Large-Scale Population-Based Study
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Ariel Israel
      – PersonEntity:
          Name:
            NameFull: Eugene Merzon
      – PersonEntity:
          Name:
            NameFull: Beth Krone
      – PersonEntity:
          Name:
            NameFull: Stephen V. Faraone
      – PersonEntity:
          Name:
            NameFull: Ilan Green
      – PersonEntity:
          Name:
            NameFull: Avivit Golan Cohen
      – PersonEntity:
          Name:
            NameFull: Shlomo Vinker
      – PersonEntity:
          Name:
            NameFull: Shira Cohen
      – PersonEntity:
          Name:
            NameFull: Shai Ashkenazi
      – PersonEntity:
          Name:
            NameFull: Eli Magen
      – PersonEntity:
          Name:
            NameFull: Abraham Weizman
      – PersonEntity:
          Name:
            NameFull: Iris Manor
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 03
              Type: published
              Y: 2024
          Identifiers:
            – Type: issn-print
              Value: 1087-0547
            – Type: issn-electronic
              Value: 1557-1246
          Numbering:
            – Type: volume
              Value: 28
            – Type: issue
              Value: 5
          Titles:
            – TitleFull: Journal of Attention Disorders
              Type: main
ResultId 1