RESUMEN
Abstract Objectives To investigate resilience levels in adolescents with attention-deficit hyperactivity disorder (ADHD) using quantitative measures when compared to their non-affected siblings and controls. We also aimed to investigate the correlation between resilience and depression, anxiety, intelligence quotient (IQ) and socioeconomic status, which may affect resilience levels and be potential confounders. Methods Adolescents (n=45) diagnosed with ADHD referred to an outpatient ADHD clinic, and their siblings without ADHD (n=27), with ages ranging from 12 to 17 years, were interviewed along with their parents using a semi-structured interview (Children's Interview for Psychiatric Syndromes - Parent Version). Intelligence was measured with the Block Design and Vocabulary subtests from the Wechsler Battery. Anxiety and depression were investigated using the Children State-Trait Anxiety Inventory (CSTAI) and the Child Depression Inventory (CDI), respectively. Resilience was investigated using the Resilience Scale. A control group (typically developing adolescents [TDA] and their siblings; n=39) was recruited in another outpatient facility and at two schools using the same methodology. Results Socioeconomic status and intelligence levels, which may affect resilience, were similar in all groups. Adolescents with ADHD showed lower resilience levels compared to siblings and TDA even when controlled for anxiety and depression levels, which were higher in ADHD. Resilience levels were higher in siblings than in adolescents with ADHD, and lower than in TDA - this last result without statistical significance. Conclusion In our sample, ADHD in adolescents was associated with lower resilience, even when controlled for confounders often seen in association with the disorder.
Resumo Objetivos Investigar níveis de resiliência em adolescentes com transtorno do déficit de atenção/hiperatividade (TDAH) empregando medidas quantitativas de modo comparativo a irmãos não afetados e controles. Também se investigou a correlação entre resiliência e depressão, ansiedade, quociente de inteligência (QI) e status socioeconômico, que podem afetar os níveis de resiliência e atuar como confundidores potenciais. Métodos Adolescentes (n=45) diagnosticados com TDAH e encaminhados para um serviço ambulatorial de TDAH e seus irmãos sem o transtorno (n=27), com idades entre 12 e 17 anos, foram entrevistados junto com seus pais utilizando-se uma entrevista semiestruturada (Children's Interview for Psychiatric Syndromes - Parent Version), em português). A inteligência foi mensurada com os subtestes Blocos e Vocabulário da Bateria Wechsler. Ansiedade e depressão foram investigados com o Inventário de Estado-Traço Infantil [Children State-Trait Anxiety Inventory (CSTAI)] e o Inventário de Depressão Infantil [Child Depression Inventory (CDI)], respectivamente. A resiliência foi mensurada utilizando-se a Escala de Resiliência. Um grupo controle [adolescentes com desenvolvimento típico (ADT) e seus irmãos; n=39] foi recrutado em outro serviço ambulatorial e em duas escolas, empregando a mesma metodologia. Resultados O status socioeconômico e os níveis de inteligência, que podem afetar a resiliência, foram similares em todos os grupos. Adolescentes com TDAH apresentaram menores níveis de resiliência comparados aos seus irmãos e a ADT, mesmo após ajuste para níveis de ansiedade e depressão, que eram mais altos no TDAH. Os níveis de resiliência foram mais altos em irmãos do que nos portadores de TDAH, porém menores que em ADT - este último resultado sem significância estatística. Conclusão Em nossa amostra, adolescentes com TDAH apresentaram menor resiliência, mesmo após controle para confundidores habitualmente associados ao transtorno.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Trastorno por Déficit de Atención con Hiperactividad/psicología , Resiliencia Psicológica , Trastornos de Ansiedad/psicología , Escalas de Valoración Psiquiátrica , Salud de la Familia , Análisis de Varianza , Trastorno Depresivo/psicologíaRESUMEN
OBJECTIVES: To investigate resilience levels in adolescents with attention-deficit hyperactivity disorder (ADHD) using quantitative measures when compared to their non-affected siblings and controls. We also aimed to investigate the correlation between resilience and depression, anxiety, intelligence quotient (IQ) and socioeconomic status, which may affect resilience levels and be potential confounders. METHODS: Adolescents (n=45) diagnosed with ADHD referred to an outpatient ADHD clinic, and their siblings without ADHD (n=27), with ages ranging from 12 to 17 years, were interviewed along with their parents using a semi-structured interview (Children's Interview for Psychiatric Syndromes - Parent Version). Intelligence was measured with the Block Design and Vocabulary subtests from the Wechsler Battery. Anxiety and depression were investigated using the Children State-Trait Anxiety Inventory (CSTAI) and the Child Depression Inventory (CDI), respectively. Resilience was investigated using the Resilience Scale. A control group (typically developing adolescents [TDA] and their siblings; n=39) was recruited in another outpatient facility and at two schools using the same methodology. RESULTS: Socioeconomic status and intelligence levels, which may affect resilience, were similar in all groups. Adolescents with ADHD showed lower resilience levels compared to siblings and TDA even when controlled for anxiety and depression levels, which were higher in ADHD. Resilience levels were higher in siblings than in adolescents with ADHD, and lower than in TDA - this last result without statistical significance. CONCLUSION: In our sample, ADHD in adolescents was associated with lower resilience, even when controlled for confounders often seen in association with the disorder.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/psicología , Resiliencia Psicológica , Adolescente , Análisis de Varianza , Trastornos de Ansiedad/psicología , Trastorno Depresivo/psicología , Salud de la Familia , Femenino , Humanos , Masculino , Escalas de Valoración PsiquiátricaRESUMEN
OBJECTIVE: To perform a pilot study to investigate the association between working memory and cortical thickness in a sample of attention deficit/hyperactivity disorder (ADHD) children. METHODS: Seventeen children aged 7-10 years diagnosed with ADHD and 16 healthy children underwent a magnetic resonance scan for cortical thickness measurements. Data was correlated with working memory performance using the Backwards Digit Span subtest of the Wechsler Intelligence Scale for Children. RESULTS: Working memory impairment, evidenced by lower scores on the Backwards Digit Span, was observed in patients with ADHD compared to healthy controls. There was a direct correlation between working memory and cortical thickness of the left medial temporal lobe (Spearman's correlation coefficient: 0.499; p < 0.005). CONCLUSIONS: Our data suggests, for the first time, a correlation between working memory, evaluated by the Backwards Digit Span, and left medial temporal cortical thickness.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Memoria a Corto Plazo/fisiología , Lóbulo Temporal/anatomía & histología , Lóbulo Temporal/fisiopatología , Factores de Edad , Estudios de Casos y Controles , Niño , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Pruebas Neuropsicológicas , Proyectos Piloto , Valores de Referencia , Factores Sexuales , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Lóbulo Temporal/diagnóstico por imagen , Escalas de WechslerRESUMEN
ABSTRACT Objective To perform a pilot study to investigate the association between working memory and cortical thickness in a sample of attention deficit/hyperactivity disorder (ADHD) children. Methods Seventeen children aged 7-10 years diagnosed with ADHD and 16 healthy children underwent a magnetic resonance scan for cortical thickness measurements. Data was correlated with working memory performance using the Backwards Digit Span subtest of the Wechsler Intelligence Scale for Children. Results Working memory impairment, evidenced by lower scores on the Backwards Digit Span, was observed in patients with ADHD compared to healthy controls. There was a direct correlation between working memory and cortical thickness of the left medial temporal lobe (Spearman’s correlation coefficient: 0.499; p < 0.005). Conclusions Our data suggests, for the first time, a correlation between working memory, evaluated by the Backwards Digit Span, and left medial temporal cortical thickness.
RESUMO Objetivo Realizar estudo piloto para investigar a associação entre memória de trabalho e espessura cortical em crianças com transtorno de défict de atenção e hiperatividade (TDAH). Métodos Dezessete crianças com TDAH, entre 7 e 10 anos, e dezesseis crianças saudáveis foram submetidas a ressonância magnética para aferição de espessura cortical. Os dados foram correlacionados com desempenho da memória de trabalho usando a ordem inversa do subteste Dígitos da Escala de Inteligência Wechsler para Crianças. Resultados Prejuízos na memória de trabalho, evidenciado pela menor pontuação na ordem inversa do subteste Dígitos, foram observados em pacientes com TDAH, em comparação com crianças saudáveis. Observou-se correlação direta entre memória de trabalho e espessura do lobo temporal médio à esquerda (coeficiente de correlação de Spearman: 0,499; p < 0,005). Conclusões Nossos dados sugerem, pela primeira vez, uma correlação entre memória de trabalho, avaliada através da pontuação na ordem inversa do subteste Dígitos, e espessura do córtex temporal medial à esquerda.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Lóbulo Temporal/anatomía & histología , Lóbulo Temporal/fisiopatología , Memoria a Corto Plazo/fisiología , Valores de Referencia , Lóbulo Temporal/diagnóstico por imagen , Escalas de Wechsler , Imagen por Resonancia Magnética , Estudios de Casos y Controles , Proyectos Piloto , Factores Sexuales , Encuestas y Cuestionarios , Factores de Edad , Estadísticas no Paramétricas , Pruebas NeuropsicológicasRESUMEN
OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is associated with impaired daily functioning in a wide range of domains. Resilience, the ability to overcome and recover from challenges, has been scarcely investigated in ADHD and could potentially provide novel strategies for treatment. However, since ADHD is often comorbid with other clinical conditions, it is necessary to better understand if it impairs resilience levels when controlled for other variables. This pilot study is the first to investigate the correlation between quantitative measures of resilience and ADHD using strict diagnostic criteria by controlling this correlation for comorbid conditions. METHODS: Twelve adolescents diagnosed with ADHD via semi-structured interview using Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) were compared to 12 adolescents exhibiting typical development, regarding resilience, in an analysis controlled for anxiety and depression levels, socioeconomic status, and intelligence quotient (IQ). RESULTS: The ADHD group was less resilient than the control group (p < 0.01). Importantly, resilience in the ADHD group was not correlated with depression or anxiety, age, intelligence level, and socioeconomic status. CONCLUSIONS: ADHD seems to be associated with lower resilience, which cannot be explained by depression, anxiety, intelligence level, age, or socioeconomic status.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Resiliencia Psicológica , Adolescente , Factores de Edad , Ansiedad/complicaciones , Ansiedad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Trastorno por Déficit de Atención con Hiperactividad/psicología , Estudios de Casos y Controles , Estudios Transversales , Depresión/complicaciones , Depresión/epidemiología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Inteligencia , Pruebas de Inteligencia , Entrevista Psicológica , Masculino , Proyectos Piloto , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Clase SocialRESUMEN
Objective: Attention deficit hyperactivity disorder (ADHD) is associated with impaired daily functioning in a wide range of domains. Resilience, the ability to overcome and recover from challenges, has been scarcely investigated in ADHD and could potentially provide novel strategies for treatment. However, since ADHD is often comorbid with other clinical conditions, it is necessary to better understand if it impairs resilience levels when controlled for other variables. This pilot study is the first to investigate the correlation between quantitative measures of resilience and ADHD using strict diagnostic criteria by controlling this correlation for comorbid conditions.Methods:Twelve adolescents diagnosed with ADHD via semi-structured interview using Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) were compared to 12 adolescents exhibiting typical development, regarding resilience, in an analysis controlled for anxiety and depression levels, socioeconomic status, and intelligence quotient (IQ).Results: The ADHD group was less resilient than the control group (p < 0.01). Importantly, resilience in the ADHD group was not correlated with depression or anxiety, age, intelligence level, and socioeconomic status.Conclusions:ADHD seems to be associated with lower resilience, which cannot be explained by depression, anxiety, intelligence level, age, or socioeconomic status.
Objetivo: O transtorno de déficit de atenção com hiperatividade (TDAH) se associa a comprometimento funcional em diferentes domínios. Resiliência, o modo como indivíduos enfrentam e superam dificuldades, não foi investigada de modo suficiente no TDAH e poderia sugerir potenciais novas estratégias terapêuticas. Entretanto, sendo o TDAH frequentemente comórbido com outras condições clinicas, é necessário entender se ele compromete a resiliência de modo independente de outras variáveis. Este estudo piloto é o primeiro a investigar a correlação entre medidas quantitativas de resiliência e TDAH diagnosticado de modo estrito controlando-a por variáveis clínicas.Método: Os níveis de resiliência de 12 adolescentes diagnosticados com TDAH de acordo com os critérios do sistema Manual Diagnóstico e Estatístico de Transtornos Mentais, 4ª edição (DSM-IV) através de entrevista semiestruturada foram comparados aos de 12 adolescentes com desenvolvimento típico, em uma análise controlada por níveis de ansiedade e depressão, status socioeconômico e inteligência.Resultados: O grupo TDAH apresentou menor resiliência do que o grupo controle (p < 0,01). Não houve correlação entre resiliência e depressão ou ansiedade, idade, inteligência ou nível socioeconômico.Conclusões: TDAH parece estar associado a baixos níveis de resiliência que não podem ser justificados por depressão, ansiedade, inteligência, idade ou condição socioeconômica.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Resiliencia Psicológica , Ansiedad/complicaciones , Ansiedad/epidemiología , Escalas de Valoración Psiquiátrica , Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Trastorno por Déficit de Atención con Hiperactividad/psicología , Clase Social , Estudios de Casos y Controles , Proyectos Piloto , Estudios Transversales , Factores de Riesgo , Factores de Edad , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Depresión/complicaciones , Depresión/epidemiología , Inteligencia , Pruebas de Inteligencia , Entrevista PsicológicaRESUMEN
A strong genetic role in the etiology of attention-deficit hyperactivity disorder (ADHD) has been demonstrated by several studies using different methodologies. Shortcomings of genetic studies often include the lack of golden standard practices for diagnosis for ADHD, the use of categorical instead of a dimensional approach, and the disregard for assortative mating phenomenon in parents. The current study aimed to overcome these shortcomings and analyze data through a novel statistical approach, using multilevel analyses with Bayesian procedures and a specific mathematical model, which takes into account data with an elevated number of zero responses (expected in samples with few or no ADHD symptoms). Correlations of parental clinical variables (ADHD, anxiety and depression) to offspring psychopathology may vary according to gender and type of symptoms. We aimed to investigate how those variables interact within each other. One hundred families, comprising a proband child or adolescent with ADHD or a typically developing child or adolescent were included and all family members (both biological parents, the proband child or adolescent and their sibling) were examined through semi-structured interviews using DSM-IV criteria. Results indicated that: (a) maternal clinical variables (ADHD, anxiety and depression) were more correlated with offspring variables than paternal ones; (b) maternal inattention (but not hyperactivity) was correlated with both inattention and hyperactivity in the offspring; (c) maternal anxiety was correlated with offspring inattention; on the other hand, maternal inattention was correlated with anxiety in the offspring. Although a family study design limits the possibility of revealing causality and cannot disentangle genetic and environmental factors, our findings suggest that ADHD, anxiety and depression are variables that correlate in families and should be addressed together. Maternal variables significantly correlated with offspring variables, but the paternal variables did not.
Asunto(s)
Ansiedad/epidemiología , Ansiedad/genética , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/genética , Depresión/epidemiología , Depresión/genética , Padres , Adolescente , Adulto , Teorema de Bayes , Brasil/epidemiología , Niño , Factores de Confusión Epidemiológicos , Femenino , Humanos , Masculino , Modelos Estadísticos , Análisis Multinivel , Factores Sexuales , HermanosRESUMEN
BACKGROUND Functional impairment is needed to make an attention deficit hyperactivity disorder (ADHD) diagnosis, but there is a paucity of instruments addressing this issue. OBJECTIVE Perform psychometric analysis of a functional impairment scale (FIE). METHODS A sample of 320 individuals, including ADHD probands, their siblings and parents, filled the FIE. We analyzed psychometric properties for the entire sample and age groups. Factor structure was determined by a principal component factor analysis, using oblique rotation with Kaiser normalization and Eigenvalues higher than 1. Cronbach’s alpha and Spearman-Brown were calculated. RESULTS Family analysis revealed four components: a) “family life”, b) “self-perception”, c) “performance” and d) “social life”. Adults’ analysis revealed two components: a) “family life, social life and self-perception” and b) “performance”. Children showed the domains: a) “performance and social life”, b) “self-perception” and c) “family life” components. Cronbach’s alpha were above 0.9 in all components. DISCUSSION Results revealed up to four domains depending on the group considered. Different life demands might explain the variability of domains on the groups. .
Asunto(s)
Humanos , Masculino , Femenino , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Entrevistas como Asunto , Relaciones FamiliaresRESUMEN
BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is associated with school failure. Inattention has been mainly implicated for this association. Oppositional-defiant disorder's (ODD) impact on academic performance remains controversial, because of the high comorbidity between ODD and ADHD. OBJECTIVE: To understand the role of inattention (IN), hyperactivity (H/I) and ODD in school failure. METHOD: Parents and teachers filled out SNAP-IV questionnaires for 241 / 6th grade students. The associations of the scores of oppositional-defiant (OP), H/I and IN symptoms with school year failure were calculated. RESULTS: IN was strongly correlated with school failure. H/I and OP were not associated with school failure, when controlled for IN. CONCLUSION: OP and H/I symptoms do not play an important role in school failure, when controlled for IN symptoms. Our study supports the cross-cultural role of IN as a major predictor of school failure.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Déficit de la Atención y Trastornos de Conducta Disruptiva/complicaciones , Discapacidades para el Aprendizaje/etiología , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Déficit de la Atención y Trastornos de Conducta Disruptiva/diagnóstico , Niño , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is associated with school failure. Inattention has been mainly implicated for this association. Oppositional-defiant disorder's (ODD) impact on academic performance remains controversial, because of the high comorbidity between ODD and ADHD. OBJECTIVE: To understand the role of inattention (IN), hyperactivity (H/I) and ODD in school failure. METHOD: Parents and teachers filled out SNAP-IV questionnaires for 241 / 6th grade students. The associations of the scores of oppositional-defiant (OP), H/I and IN symptoms with school year failure were calculated. RESULTS: IN was strongly correlated with school failure. H/I and OP were not associated with school failure, when controlled for IN. CONCLUSION: OP and H/I symptoms do not play an important role in school failure, when controlled for IN symptoms. Our study supports the cross-cultural role of IN as a major predictor of school failure.
Transtorno do déficit de atenção e hiperatividade (TDAH) está fortemente correlacionado a fracasso escolar. Desatenção (DA) parece ser primordialmente responsável por essa associação. A influência de transtorno desafiador de oposicão (TDO) sobre o desempenho acadêmico continua a ser controversa, principalmente devido à alta comorbidade entre TDO e TDAH. OBJETIVO: Entender melhor o papel da DA, hiperatividade/impulsividade (H/I) e sintomas opositivo-desafiadores (OP) no fracasso escolar. MÉTODO: Duzentos e quarenta e um estudantes da 6ª série foram avaliados com os questionários de Swanson, Nolan e Pelham (SNAP-IV), preenchidos pelos pais e professores. As associações entre as sub-escalas de OP, H/I e DA, com o número de notas "I" ("insuficiente") e com reprovação escolar foram calculadas. RESULTADOS: Sintomas OP não foram correlacionados com o número de notas "I", após o controle para a sua associação com H/I e DA. DA se associou com fracasso escolar. H/I não se correlacionou com fracasso escolar, uma vez controlada a sua associação com DA. CONCLUSÃO: OP e H/I não exercem papel importante no fracasso escolar, uma vez controladas as suas associações com DA. Esse estudo ressalta, em amostra brasileira, o papel transcultural da DA como ameaça ao bom desempenho escolar. A associação entre transtornos do aprendizado e sintomas de DA precisa ser mais extensamente investigada.
Asunto(s)
Niño , Femenino , Humanos , Masculino , Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Déficit de la Atención y Trastornos de Conducta Disruptiva/complicaciones , Discapacidades para el Aprendizaje/etiología , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Déficit de la Atención y Trastornos de Conducta Disruptiva/diagnóstico , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Encuestas y CuestionariosRESUMEN
Este artigo tem como objetivo fazer uma atualização acerca dos conceitos de resiliência, fatores de risco e fatores de proteção, correlacionando-os com o impacto do transtorno do déficit de atenção/hiperatividade (TDAH). Resiliência descreve a capacidade do indivíduo de, uma vez exposto a estresse, resistir e vencê-lo. A família estß envolvida no conceito de resiliência, tanto pela sua capacidade de interferir na resiliência dos seus indivíduos componentes quanto na habilidade de responder como uma unidade funcional resiliente, diante do estresse. O relacionamento com figuras afetivamente importantes na infância, o número pequeno de estressores, e o entendimento subjetivo em relação ao estressor são fatores que influenciam a capacidade de ser resiliente. A ausência de comorbidades, de problemas de conduta ou de relacionamento com colegas, bem como de sintomas somßticos ou problemas de coordenação, estß associada com menor impacto negativo do TDAH.
The aim of this article is to perform an update regarding the definition of resilience, risk factors and protective factors, and to correlate them with the impact of Attention Deficit/Hyperactivity Disorder (ADHD). Resilience is the capacity to resist and overcome adversity. Family is associated with the concept of resilience not only because of its capacity to interfere with the resilience of its members, but also because of its ability to respond as a functional unit when challenged with adversity. Relationships with affectively meaningful figures during childhood, the number of adverse events to which the individual is submitted and his subjective understanding of the stressor modify the ability to be resilient. ADHD has a smaller negative impact in children without conduct problems, social relationship problems, somatic symptoms or coordination problems.
Asunto(s)
Humanos , Niño , Adaptación Psicológica , Familia/psicología , Factores Protectores , Resiliencia Psicológica , Trastorno por Déficit de Atención con Hiperactividad/psicología , Brasil , Factores de Riesgo , Conducta SocialRESUMEN
O transtorno do déficit de atenção e hiperatividade (TDAH) é um dos transtornos neurobiológicos com maior prevalência na infância e pode implicar dificuldades no funcionamento conjugal dos pais das crianças afetadas, bem como sofrer influência do mesmo. OBJETIVO: Realizar uma revisão sistemática acerca dos aspectos conjugais em famílias de crianças com TDAH, relacionando-os com outras variáveis, como a presença de comorbidades, aspectos socioeconômicos e saúde mental dos pais. MÉTODOS: Revisão sistemática de literatura por meio do PubMed entre os anos de 1996 e 2006, utilizando os termos "ADD", "ADHD", "Attention-Deficit Hyperactivity Disorder", "Attention-Deficit", "marital conflict" e "family". RESULTADOS: Dezesseis estudos dentre 628 publicações iniciais e 55 artigos posteriormente incluídos pelas referências bibliográficas foram avaliados. O relacionamento conjugal aparece comprometido em grande parte da literatura, principalmente nos pais daquelas crianças que apresentam distúrbio desafiador e de oposição (DDO) ou distúrbio de conduta comórbidos. Contudo, resultados opostos também são encontrados em diversas pesquisas. CONCLUSÕES: Os resultados de pesquisas referentes ao funcionamento conjugal de pais destas crianças são heterogêneos. É preciso que sejam feitos estudos longitudinais, que possam esclarecer o impacto do transtorno nos conflitos conjugais de pais de portadores, bem como a influência destes últimos na expressão clínica do transtorno.
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurobiological disorders among children and might either influence or be influenced by problems in marital functioning of the parents of affected children. Studies aimed at investigating marital functioning in parents of these children have found controversial results. OBJETIVE: To perform a systematic review about the marital aspects of families with ADHD children and, to correlate those aspects with other variables, like the presence of comorbidities, socioeconomical aspects and parents' mental health. METHODS: A systematic review of the literature was conducted in Pubmed between 1996 and 2006, using the following keywords: "ADD", "ADHD", "Attention-Deficit Hyperactivity Disorder", "Attention-Deficit", "marital conflict", and "family". RESULTS: Sixteen of the 628 initial articles and 55 additional papers included in a following phase, based on bibliographical references, were evaluated. Impairment in marital relationships has been documented in most studies, specially when ADHD is comorbid with Oppositional-Defiant Disorder (ODD) or Conduct Disorder (CD). However, studies indicating normal marital functioning also exist. CONCLUSIONS: Study results concerning ADHD and marital dysfunction have conflicting results. Futures longitudinal studies will be necessary to clarify the impact of ADHD in marital conflict of parents of children with ADHD, and also to determine the influence of the marital conflicts in the clinical expression of the disorder.