RESUMEN
OBJECTIVE: The objective of the present study is to investigate the association between attention deficit/hyperactivity disorder (ADHD), predominantly inattentive type (ADHD-I) and prenatal, delivery and early postnatal complications (PDPC). METHOD: In a case-control design, we assessed a sample of 124 children and adolescents with ADHD-I and 124 non-ADHD controls (6-17 years old) from both a non-referred (n = 200) and a clinical sample (n = 48). Cases and controls, matched by gender and age, were systematically evaluated through structured diagnostic interviews. Prenatal, delivery and early postnatal complications (PDPC), as well as potential confounders were evaluated by direct interview with biological mothers. RESULTS: Conditional logistic regression analysis showed that children and adolescents whose mothers presented more PDPC had a significantly higher risk for ADHD-I (p = 0.005; OR = 1.25; CI 95%: 1.1-1.5). CONCLUSIONS: In a case-control study, we expanded to ADHD-I previous findings suggesting the association between perinatal factors and broadly defined ADHD. Due to the preventable nature of some of these PDPC, our results have clear impact in public mental health policies.
OBJETIVO: O objetivo desse estudo é investigar a associação entre complicações perinatais (complicações ocorridas nos períodos pré, peri e pós-natal imediato -CPPs) e transtorno de déficit de atenção/hiperatividade (TDAH) do subtipo desatento (TDAH-D). MÉTODO: Em um estudo de casos e controles, foram avaliadas 124 crianças e adolescentes (6-17 anos) com TDAH-D e 124 controles sem a doença, provenientes tanto de uma amostra populacional (n = 200), quanto de uma amostra clínica (n = 48). Casos e controles, pareados por gênero e idade, foram sistematicamente avaliados através de entrevistas diagnósticas estruturadas. Informações sobre as complicações ocorridas durante os períodos pré, peri e pós-natal imediato (CPPs), assim como sobre potencias confundidores, foram obtidas através de entrevistas realizadas diretamente com as mães biológicas. RESULTADOS:A análise de regressão logística condicional mostrou que para as crianças e adolescentes cujas mães apresentaram maior número de CPPs, o risco de TDAH-D foi significativamente mais elevado (p = 0.005; OR = 1.25; IC 95%: 1.1-1.5). CONCLUSÕES: Em um estudo de caso-controle, foi possível expandir, para o TDAH predominantemente desatento, os achados prévios que sugeriam a associação entre complicações perinatais e TDAH sem um subtipo específico. Em virtude da possibilidade de prevenção de algumas dessas complicações, nossos resultados podem exercer impacto sobre políticas públicas de saúde.
Asunto(s)
Adolescente , Adulto , Femenino , Humanos , Embarazo , Adulto Joven , Trastorno por Déficit de Atención con Hiperactividad/etiología , Complicaciones del Trabajo de Parto , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Estudios de Casos y Controles , Resultado del Embarazo , Factores de RiesgoRESUMEN
OBJECTIVE: The objective of the present study is to investigate the association between attention deficit/hyperactivity disorder (ADHD), predominantly inattentive type (ADHD-I) and prenatal, delivery and early postnatal complications (PDPC). METHOD: In a case-control design, we assessed a sample of 124 children and adolescents with ADHD-I and 124 non-ADHD controls (6-17 years old) from both a non-referred (n = 200) and a clinical sample (n = 48). Cases and controls, matched by gender and age, were systematically evaluated through structured diagnostic interviews. Prenatal, delivery and early postnatal complications (PDPC), as well as potential confounders were evaluated by direct interview with biological mothers. RESULTS: Conditional logistic regression analysis showed that children and adolescents whose mothers presented more PDPC had a significantly higher risk for ADHD-I (p = 0.005; OR = 1.25; CI 95%: 1.1-1.5). CONCLUSIONS: In a case-control study, we expanded to ADHD-I previous findings suggesting the association between perinatal factors and broadly defined ADHD. Due to the preventable nature of some of these PDPC, our results have clear impact in public mental health policies.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/etiología , Complicaciones del Trabajo de Parto , Adolescente , Adulto , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Estudios de Casos y Controles , Femenino , Humanos , Embarazo , Resultado del Embarazo , Factores de Riesgo , Adulto JovenRESUMEN
There are controversial evidence in the literature on the role of comorbid anxiety disorders (ANX) in the improvement of attention-deficit/hyperactivity disorder (ADHD) symptoms with methylphenidate (MPH) treatment. Our main objective was to assess differences in the response to MPH treatment in children and adolescents with ADHD with and without comorbid ANX. We extensively evaluated response to MPH in a naturalistic study of 280 children and adolescent with ADHD according to DSM-IV criteria. Psychiatric diagnoses (ADHD, ANX, and other comorbidities) were assessed by semi-structured interviews (K-SADS-E). Response to MPH was assessed by means of total score in the Swanson, Nolan, and Pelham Scale-version IV (SNAP-IV) after 1 month of treatment. There was no significant between-group difference in the response to treatment with MPH after 1 month either when SNAP-IV scores were assessed dimensionally or categorically (moderate response) (P > 0.05). Our findings suggest that comorbid ANX do not interfere in the response to MPH on core ADHD symptoms.