Association of mental disorders and strabismus among South Korean children and adolescents: a nationwide population-based study

Graefes Arch Clin Exp Ophthalmol. 2022 Apr;260(4):1353-1365. doi: 10.1007/s00417-021-05325-7. Epub 2021 Oct 26.

Abstract

Purpose: The aim of this study is to determine the association between mental disorders and strabismus in South Korean children and adolescents.

Methods: Using data from the Korean National Health Claims Database from 2011 to 2017, the prevalence rates of mental illnesses and odds ratio were calculated. Children and adolescents (1-19 years) with strabismus and their randomly selected nonstrabismic age- and sex-matched controls (1:1) were enrolled. The odds ratios were adjusted for preterm birth, cerebral palsy, and mental retardation. Subgroup analysis was performed according to sex and the type of strabismus.

Results: A total of 327,076 subjects (male, 158,597; female, 168,479) identified as strabismus patients were enrolled. After adjusting for preterm birth, cerebral palsy, and mental retardation, the corrected odds ratio of overall mental illness was 1.10 (95% CI, 1.08-1.12) for the strabismus group compared to the controls: 1.7 (95% CI, 1.62-1.78) for developmental disorder, 1.36 (95% CI, 1.27-1.45) for pervasive developmental disorder (autism), 1.14 (95% CI, 1.10-1.17) for attention-deficit hyperactivity disorder (ADHD), 1.15 (95% CI, 1.05-1.27) for obsessive-compulsive disorder (OCD), 1.08 (95% CI, 1.05-1.11) for pediatric behavioral and emotional disorders, 0.93 (95% CI, 0.88-0.99) for post-traumatic stress disorder (PTSD), and 0.85 (95% CI, 0.82-0.89) for tic disorder.

Conclusion: South Korean children and adolescents with strabismus had a higher relative risk for various types of mental disorders such as a developmental disorder, autism, ADHD, and OCD than the controls, whereas they had a relatively lower risk of tic disorder.

Keywords: Autism; ADHD; Developmental disorder; Mental illness; Obsessive compulsive disorder; Strabismus.

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit and Disruptive Behavior Disorders / epidemiology
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Comorbidity
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mental Disorders* / epidemiology
  • Obsessive-Compulsive Disorder / epidemiology
  • Premature Birth
  • Republic of Korea / epidemiology
  • Strabismus* / epidemiology
  • Stress Disorders, Post-Traumatic / epidemiology
  • Tic Disorders / epidemiology