RESUMO
The Swanson, Nolan, and Pelham scale version IV (SNAP-IV) is widely used to assess symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in children and adolescents. Nevertheless, there is insufficient data to support its use in preschool children. The study had three goals: First, to test the factorial validity of the three correlated-factors model of ADHD and ODD items of the SNAP-IV. Second, to investigate the measurement invariance of the items over time (6-month longitudinal interval) and by sex. Third, to investigate the convergent validity and method-specific influences on ADHD/ODD assessments with respect to multiple raters (parents/teachers) of children's symptoms. Participants were 618 preschool children (3.5-6 years) at baseline and 6-month follow-up. For model testing, we used confirmatory factor analysis for categorical observed variables. Method and trait effects were examined using the CT-C(M-1) model. The analyses showed partial measurement invariance over time and according to sex. Moreover, strong rater-specific effects were detected. The implication of the results for construct validation of the instrument and clinical assessment of ADHD and ODD traits are discussed.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtornos de Deficit da Atenção e do Comportamento Disruptivo , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Pré-Escolar , Análise Fatorial , Humanos , PaisRESUMO
OBJECTIVE: This study aims to describe the use of telehealth in developmental behavioral pediatric (DBP) fellowship-affiliated practices during the coronavirus disease 2019 (COVID-19) global pandemic. METHODS: An electronic survey was disseminated to all DBP fellowship-associated practice locations to determine the use of telehealth in DBP care provision, before and since the beginning of the COVID-19 pandemic. We analyzed responses using descriptive statistics. RESULTS: A total of 35 of 42 eligible practice sites responded (83% response rate). Most sites (51.4%) reported using telehealth less than once per month before the COVID-19 pandemic. Since the onset of COVID-19, 100% of programs reported conducting video-based telehealth visits multiple days per week. Most sites reported conducting evaluations and follow-up visits for attention-deficit/hyperactivity disorder, autism spectrum disorder, behavioral concerns, developmental delay, genetic disorders, and learning disability. Most sites were able to continue medication management by telehealth (>88%), offer interpreter services for families with limited English proficiency participating in telehealth visits (>90%), and incorporate trainees and interdisciplinary team members in telehealth visits (>90%). Greater variability was observed in sites' ability to collect telehealth practice evaluation measures. CONCLUSION: Most sites are providing evaluations and ongoing care for DBP conditions through telehealth. The rapid adoption of telehealth can have ramifications for the way that DBP care is delivered in the future; therefore, it is imperative to understand current practice patterns and variations to determine the best use of telehealth.
Assuntos
COVID-19/epidemiologia , Bolsas de Estudo/métodos , Pediatria/métodos , Telemedicina , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Criança , Desenvolvimento Infantil , Transtornos Globais do Desenvolvimento Infantil/diagnóstico , Deficiências do Desenvolvimento/diagnóstico , Humanos , Pediatria/educação , Telemedicina/métodosRESUMO
INTRODUCTION: Irritability has both mood and behavioral manifestations. These frequently co-occur, and it is unclear to what extent they are dissociable domains. We used confirmatory factor analysis and external validators to investigate the independence of mood and behavioral components of irritability. METHODS: The sample comprised 246 patients (mean age 45 years; 63% female) from four outpatient programs (depression, anxiety, bipolar, and schizophrenia) at a tertiary hospital. A clinical instrument rated by trained clinicians was specifically designed to capture irritable mood and disruptive behavior dimensionally, as well as current categorical diagnoses i.e., intermittent explosive disorder (IED); oppositional defiant disorder (ODD); and an adaptation to diagnose disruptive mood dysregulation disorder (DMDD) in adults. Confirmatory factor analysis (CFA) was used to test the best fitting irritability models and regression analyses were used to investigate associations with external validators. RESULTS: Irritable mood and disruptive behavior were both frequent, but diagnoses of disruptive syndromes were rare (IED, 8%; ODD, 2%; DMDD, 2%). A correlated model with two dimensions, and a bifactor model with one general dimension and two specific dimensions (mood and behavior) both had good fit indices. The correlated model had root mean square error of approximation (RMSEA) = 0.077, with 90% confidence interval (90%CI) = 0.071-0.083; comparative fit index (CFI) = 0.99; and Tucker-Lewis index (TLI) = 0.99, while the bifactor model had RMSEA = 0.041; CFI = 0.99; and TLI = 0.99 respectively). In the bifactor model, external validity for differentiation of the mood and behavioral components of irritability was also supported by associations between irritable mood and impairment and clinical measures of depression and mania, which were not associated with disruptive behavior. CONCLUSIONS: Psychometric and external validity data suggest both overlapping and specific features of the mood vs. disruptive behavior dimensions of irritability.
Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Humor Irritável , Transtornos do Humor/diagnóstico , Comportamento Problema , Adulto , Diagnóstico Diferencial , Análise Fatorial , Feminino , Humanos , Humor Irritável/fisiologia , Masculino , Pessoa de Meia-Idade , Ambulatório Hospitalar , Reprodutibilidade dos Testes , Centros de Atenção TerciáriaRESUMO
Abstract Introduction Irritability has both mood and behavioral manifestations. These frequently co-occur, and it is unclear to what extent they are dissociable domains. We used confirmatory factor analysis and external validators to investigate the independence of mood and behavioral components of irritability. Methods The sample comprised 246 patients (mean age 45 years; 63% female) from four outpatient programs (depression, anxiety, bipolar, and schizophrenia) at a tertiary hospital. A clinical instrument rated by trained clinicians was specifically designed to capture irritable mood and disruptive behavior dimensionally, as well as current categorical diagnoses i.e., intermittent explosive disorder (IED); oppositional defiant disorder (ODD); and an adaptation to diagnose disruptive mood dysregulation disorder (DMDD) in adults. Confirmatory factor analysis (CFA) was used to test the best fitting irritability models and regression analyses were used to investigate associations with external validators. Results Irritable mood and disruptive behavior were both frequent, but diagnoses of disruptive syndromes were rare (IED, 8%; ODD, 2%; DMDD, 2%). A correlated model with two dimensions, and a bifactor model with one general dimension and two specific dimensions (mood and behavior) both had good fit indices. The correlated model had root mean square error of approximation (RMSEA) = 0.077, with 90% confidence interval (90%CI) = 0.071-0.083; comparative fit index (CFI) = 0.99; and Tucker-Lewis index (TLI) = 0.99, while the bifactor model had RMSEA = 0.041; CFI = 0.99; and TLI = 0.99 respectively). In the bifactor model, external validity for differentiation of the mood and behavioral components of irritability was also supported by associations between irritable mood and impairment and clinical measures of depression and mania, which were not associated with disruptive behavior. Conclusions Psychometric and external validity data suggest both overlapping and specific features of the mood vs. disruptive behavior dimensions of irritability.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Humor Irritável , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos do Humor/diagnóstico , Comportamento Problema , Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Ambulatório Hospitalar , Humor Irritável/fisiologia , Reprodutibilidade dos Testes , Análise Fatorial , Diagnóstico Diferencial , Centros de Atenção TerciáriaRESUMO
AIMS: This study addressed the age of onset of conduct disorder (CD) and oppositional defiant disorder (ODD) in treatment-seeking substance use disorder (SUD) patients with and without adult attention-deficit/hyperactivity disorder (ADHD) and its association with early onset of SUD. METHODS: We examined data from the 2nd International ADHD in Substance Use Disorders Prevalence Study, including 400 adults in SUD treatment from Puerto Rico, Hungary, and Australia. ADHD, SUD, and CD/ODD were assessed with the Conners Adult ADHD Diagnostic Interview for DSM-IV, the MINI International Neuropsychiatric Interview, and the K-SADS, respectively. Cox regression analyses modeled time to emergence of CD/ODD separately for SUD patients with and without adult ADHD. Linear regression models examined associations between age of onset of SUD and presence of ADHD and adjusted for sex, age, and country. To assess the mediating role of CD/ODD on the association of ADHD with onset of SUD, adjusted regression models were estimated. RESULTS: Treatment-seeking SUD patients with ADHD presented an earlier onset of CD/ODD compared with those without ADHD. CD/ODD symptom loads were higher among the SUD and ADHD group. Age of first substance use and SUD were significantly earlier in SUD patients with ADHD, and these findings remained significant after adjustment for demographics and coexisting CD/ODD. CONCLUSIONS: ADHD is associated with earlier onset of SUD as well as with an earlier onset of more frequent and more severe disruptive behavioral disorders. These findings may inform preventive interventions to mitigate adverse consequences of ADHD.
Assuntos
Idade de Início , Transtornos de Deficit da Atenção e do Comportamento Disruptivo , Índice de Gravidade de Doença , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Austrália/epidemiologia , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Hungria/epidemiologia , Entrevistas como Assunto , Masculino , Escalas de Graduação Psiquiátrica , Porto Rico/epidemiologia , Fatores de Risco , Autorrelato , Transtornos Relacionados ao Uso de Substâncias/epidemiologiaRESUMO
Increased reaction time variability (RTV) is one of the most replicable behavioral correlates of attention-deficit/hyperactivity disorder (ADHD). However, this may not be specific to ADHD but a more general marker of psychopathology. Here we compare RT variability in individuals with ADHD and those with other childhood internalizing and externalizing conditions both in terms of standard (i.e., the standard deviation of reaction time) and alternative indices that capture low-frequency oscillatory patterns in RT variations over time thought to mark periodic lapses of attention in ADHD. A total of 667 participants (6-12 years old) were classified into non-overlapping diagnostic groups consisting of children with fear disorders (n = 91), distress disorders (n = 56), ADHD (n = 103), oppositional defiant or conduct disorder (ODD/CD; n = 40) and typically developing controls (TDC; n = 377). We used a simple two-choice reaction time task to measure reaction time. The strength of oscillations in RTs across the session was extracted using spectral analyses. Higher RTV was present in ADHD compared to all other disorder groups, effects that were equally strong across all frequency bands. Interestingly, we found that lower RTV to characterize ODD/CD relative to TDC, a finding that was more pronounced at lower frequencies. In general, our data support RTV as a specific marker of ADHD. RT variation across time in ADHD did not show periodicity in a specific frequency band, not supporting that ADHD RTV is the product of spontaneous periodic lapses of attention. Low-frequency oscillations may be particularly useful to differentiate ODD/CD from TDC.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Transtorno da Conduta/fisiopatologia , Modelos Neurológicos , Transtornos Fóbicos/fisiopatologia , Tempo de Reação/fisiologia , Estresse Psicológico/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Criança , Comportamento de Escolha/fisiologia , Transtorno da Conduta/diagnóstico , Endofenótipos , Feminino , Humanos , MasculinoRESUMO
Youth who exhibit externalizing problems during childhood and adolescence are at an increased risk for a wide range of detrimental life outcomes. Despite the profound consequences of externalizing problems for children, their families, and their communities, we know less about the precise trajectory of externalizing symptoms across late childhood and adolescence, because of the paucity of fine-grained longitudinal research. The present study examined the development of externalizing symptoms in a large sample (N = 674) of Mexican-origin youth, assessed annually from age 10 to 17. Specifically, we conducted analyses to better understand the trajectories of attention-deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms (and their codevelopment), as well as how gender and cultural factors influence symptom trajectories. On average, ADHD symptoms slowly declined from age 10 to 17; ODD symptoms increased until age 13 and then declined thereafter; and, CD symptoms slowly increased until age 15 and then leveled off. ADHD, ODD, and CD symptoms predicted change in each other, indicating youth may accumulate multiple forms of externalizing problems over time. Boys reported fewer externalizing problems than girls, contrary to expectations. Consistent with the Immigrant Paradox, we found that 2nd + generation youth, youth who endorsed fewer traditional Mexican cultural values (traditional gender roles, traditional family values, and religiosity), and youth who engaged in less Spanish/more English language use were at increased risk for exhibiting ADHD, ODD, and CD symptoms from childhood through adolescence. We discuss the theoretical and practical implications of these developmental patterns among Mexican-origin youth. (PsycINFO Database Record
Assuntos
Aculturação , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtorno da Conduta/diagnóstico , Americanos Mexicanos/estatística & dados numéricos , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Criança , Transtorno da Conduta/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Escalas de Graduação Psiquiátrica , Fatores de RiscoRESUMO
Abstract: Objective: This study aims to generate evidence on intellectual development disorders (IDD) in Mexico. Materials and methods: IDD disease burden will be estimated with a probabilistic model, using population-based surveys. Direct and indirect costs of catastrophic expenses of families with a member with an IDD will be evaluated. Genomic characterization of IDD will include: sequencing participant exomes and performing bioinformatics analyses to identify de novo or inherited variants through trio analysis; identifying genetic variants associated with IDD, and validating randomly selected variants by polymerase chain reaction (PCR) and sequencing or real-time quantitative PCR (qPCR). Delphi surveys will be done on best practices for IDD diagnosis and management. An external evaluation will employ qualitative case studies of two social and labor inclusion programs for people with IDD. Conclusions: The results will constitute scientific evidence for the design, promotion and evaluation of public policies, which are currently absent on IDD.
Resumen: Objetivo: Esta investigación busca generar evidencia sobre trastornos del desarrollo intelectual (TDI) en México. Material y métodos: La carga de la enfermedad por TDI se estimará con un modelo probabilístico usando encuestas poblacionales. Se estimarán costos directos e indirectos de gastos catastróficos de familias con un integrante conTDI. La caracterización genómica deTDI incluirá secuenciar exomas, realizar análisis bioinformático para identificar variantes de novo o heredadas a través de análisis de tríos, identificar variantes genéticas asociadas con TDI, y validar variantes aleatoriamente seleccionadas con reacción en cadena de polimerasa y secuenciación o qPCR. Se harán encuestas Delphi sobre mejores prácticas de diagnóstico y manejo de TDI. Una evaluación externa empleará estudios cualitativos de caso de dos programas de inclusión social y laboral para personas con TDI. Conclusiones: Los resultados serán evidencia científica que podrá ser la base para el diseño, promoción y evaluación de políticas públicas, actualmente ausentes para TDI.
Assuntos
Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/economia , Deficiência Intelectual/genética , Deficiência Intelectual/terapia , Variação Genética , Doença Catastrófica/economia , Inquéritos e Questionários , Efeitos Psicossociais da Doença , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/economia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/genética , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Custos e Análise de Custo , Genômica , Obesidade Infantil/diagnóstico , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/terapia , MéxicoRESUMO
OBJECTIVE:: This study aims to generate evidence on intellectual development disorders (IDD) in Mexico. MATERIALS AND METHODS:: IDD disease burden will be estimated with a probabilistic model, using population-based surveys. Direct and indirect costs of catastrophic expenses of families with a member with an IDD will be evaluated. Genomic characterization of IDD will include: sequencing participant exomes and performing bioinformatics analyses to identify de novo or inherited variants through trio analysis; identifying genetic variants associated with IDD, and validating randomly selected variants by polymerase chain reaction (PCR) and sequencing or real-time quantitative PCR (qPCR). Delphi surveys will be done on best practices for IDD diagnosis and management. An external evaluation will employ qualitative case studies of two social and labor inclusion programs for people with IDD. CONCLUSIONS:: The results will constitute scientific evidence for the design, promotion and evaluation of public policies, which are currently absent on IDD.
Assuntos
Deficiência Intelectual , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/economia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/genética , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/economia , Transtorno do Espectro Autista/genética , Transtorno do Espectro Autista/terapia , Doença Catastrófica/economia , Efeitos Psicossociais da Doença , Custos e Análise de Custo , Variação Genética , Genômica , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/economia , Deficiência Intelectual/genética , Deficiência Intelectual/terapia , México , Obesidade Infantil/diagnóstico , Obesidade Infantil/economia , Obesidade Infantil/genética , Obesidade Infantil/terapia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Both inhibitory-based executive functioning (IB-EF) and basic information processing (BIP) deficits are found in clinic-referred attention deficit hyperactivity disorder (ADHD) samples. However, it remains to be determined whether: (1) such deficits occur in non-referred samples of ADHD; (2) they are specific to ADHD; (3) the co-morbidity between ADHD and oppositional defiant disorder/conduct disorder (ODD/CD) has additive or interactive effects; and (4) IB-EF deficits are primary in ADHD or are due to BIP deficits. METHOD: We assessed 704 subjects (age 6-12 years) from a non-referred sample using the Development and Well-Being Assessment (DAWBA) and classified them into five groups: typical developing controls (TDC; n = 378), Fear disorders (n = 90), Distress disorders (n = 57), ADHD (n = 100), ODD/CD (n = 40) and ADHD+ODD/CD (n = 39). We evaluated neurocognitive performance with a Two-Choice Reaction Time Task (2C-RT), a Conflict Control Task (CCT) and a Go/No-Go (GNG) task. We used a diffusion model (DM) to decompose BIP into processing efficiency, speed-accuracy trade-off and encoding/motor function along with variability parameters. RESULTS: Poorer processing efficiency was found to be specific to ADHD. Faster encoding/motor function differentiated ADHD from TDC and from fear/distress whereas a more cautious (not impulsive) response style differentiated ADHD from both TDC and ODD/CD. The co-morbidity between ADHD and ODD/CD reflected only additive effects. All ADHD-related IB-EF classical effects were fully moderated by deficits in BIP. CONCLUSIONS: Our findings challenge the IB-EF hypothesis for ADHD and underscore the importance of processing efficiency as the key specific mechanism for ADHD pathophysiology.
Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Função Executiva/fisiologia , Inibição Psicológica , Processos Mentais/fisiologia , Modelos Estatísticos , Análise de Variância , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Estudos de Casos e Controles , Criança , Comorbidade , Diagnóstico Diferencial , Medo/psicologia , Feminino , Humanos , Entrevista Psicológica , Masculino , Testes Neuropsicológicos/estatística & dados numéricos , Tempo de Reação/fisiologia , Estresse Psicológico/psicologiaRESUMO
Irritability is defined as a low threshold to experience anger in response to frustration. It is one of the most common symptoms in youth and is part of the clinical presentation of several disorders. Irritability can present early in life and is a predictor of long-term psychopathology; yet, the diagnostic status of irritability is a matter of intense debate. In the present article, we address two main components of the debate regarding irritability in youth: the misdiagnosis of chronic irritability as pediatric bipolar disorder, and the proposal of a new diagnosis in the DSM-5, disruptive mood dysregulation disorder, whose defining symptoms are chronic irritability and temper outbursts.
Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtorno Bipolar/diagnóstico , Humor Irritável , Transtornos do Humor/diagnóstico , Adolescente , Ira , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Transtorno Bipolar/terapia , Criança , Diagnóstico Diferencial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Humor Irritável/efeitos dos fármacos , Transtornos do Humor/terapia , Escalas de Graduação PsiquiátricaAssuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtorno Bipolar/diagnóstico , Adolescente , Afeto , Fatores Etários , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/tratamento farmacológico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/psicologia , Transtorno Bipolar/terapia , Criança , HumanosRESUMO
Irritability is defined as a low threshold to experience anger in response to frustration. It is one of the most common symptoms in youth and is part of the clinical presentation of several disorders. Irritability can present early in life and is a predictor of long-term psychopathology; yet, the diagnostic status of irritability is a matter of intense debate. In the present article, we address two main components of the debate regarding irritability in youth: the misdiagnosis of chronic irritability as pediatric bipolar disorder, and the proposal of a new diagnosis in the DSM-5, disruptive mood dysregulation disorder, whose defining symptoms are chronic irritability and temper outbursts.
Assuntos
Adolescente , Criança , Humanos , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtorno Bipolar/diagnóstico , Humor Irritável , Transtornos do Humor/diagnóstico , Ira , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Transtorno Bipolar/terapia , Diagnóstico Diferencial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humor Irritável/efeitos dos fármacos , Transtornos do Humor/terapia , Escalas de Graduação PsiquiátricaRESUMO
Since approximately 70% of adult patients with attention-deficit/hyperactivity disorder (ADHD) have at least one comorbid disorder, rating of impairment specifically attributable to ADHD is a hard task. Despite the evidence linking environmental adversities with negative outcomes in ADHD, life events measures have not been used to rate the disorder impairment. The present study tested for the first time the hypothesis that increased ADHD severity is associated with an increase in negative recent life events, independently of comorbidity status. The psychiatric diagnoses of 211 adult ADHD outpatients were based on DSM-IV criteria assessed through structured interviews (K-SADS-E for ADHD and ODD, MINI for ASPD and SCID-IV-R for other comorbidities). ADHD severity was evaluated with the Swanson, Nolan and Pelham rating scale (SNAP-IV) and recent life events with the Life Experience Survey. Higher SNAP-IV inattention and hyperactivity scores, female gender, lower socioeconomic status and the presence of comorbid mood disorders were associated with negative life events. Poisson regression models with adjustment for possible confounders confirmed the effect of inattention and hyperactivity severity on negative life events. Our results suggest that the negative life events experienced by these patients are associated to the severity of ADHD independently from comorbid psychiatric disorders.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Acontecimentos que Mudam a Vida , Transtornos do Humor/psicologia , Qualidade de Vida/psicologia , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Índice de Gravidade de Doença , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
El Trastorno de Desatención e Hiperactividad (TDHA) esposiblemente la patología infantil que más auge ha adquiridoen las dos últimas décadas. Este trastorno es considerado,en muchos casos, una problemática social, tanto por sucada vez mayor prevalencia, como por el involucramientode distintos sectores en la misma. Ello ha llevado a queexista una fuerte presión desde la institución escolar y enalgunos casos también de la familia para que esta patologíainfantil encuentre una rápida resolución mediante el usode psicofármacos. En la actualidad, sin embargo, se hapuesto en duda los fundamentos científicos que muestranuna prevalencia elevada para este trastorno hasta alcanzar,en algunos casos, el 20% del total de población infantil.Ello conlleva a la discusión acerca de si es posible sosteneral TDHA como una entidad diagnóstica independiente, osi solo se trata de un conjunto de síntomas relativamenteindependientes entre sí(AU)
The disorder of inattention and hyperactivity is arguablythe child pathology more boom has acquired in the past twodecades, considered in many cases a real social problem, its increasing prevalence, both sectors that are involved with regard to the same. This hasled to that there is strong pressure from the school and in some cases also the family sothat this child pathology find a quick resolution through the use of psychoactive drugs.However, it should be questioned about the scientific foundations who claim a high andbelief so high prevalence for this pathology, reaching almost, in some cases, 20 per cent.Alternatively, if it is possible to hold to the TDHA as an independent diagnosed entity, orif it is only a relatively independent symptoms set with each other(AU)
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/classificação , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtorno do Deficit de Atenção com HiperatividadeRESUMO
El Trastorno de Desatención e Hiperactividad (TDHA) esposiblemente la patología infantil que más auge ha adquiridoen las dos últimas décadas. Este trastorno es considerado,en muchos casos, una problemática social, tanto por sucada vez mayor prevalencia, como por el involucramientode distintos sectores en la misma. Ello ha llevado a queexista una fuerte presión desde la institución escolar y enalgunos casos también de la familia para que esta patologíainfantil encuentre una rápida resolución mediante el usode psicofármacos. En la actualidad, sin embargo, se hapuesto en duda los fundamentos científicos que muestranuna prevalencia elevada para este trastorno hasta alcanzar,en algunos casos, el 20% del total de población infantil.Ello conlleva a la discusión acerca de si es posible sosteneral TDHA como una entidad diagnóstica independiente, osi solo se trata de un conjunto de síntomas relativamenteindependientes entre sí
The disorder of inattention and hyperactivity is arguablythe child pathology more boom has acquired in the past twodecades, considered in many cases a real social problem, its increasing prevalence, both sectors that are involved with regard to the same. This hasled to that there is strong pressure from the school and in some cases also the family sothat this child pathology find a quick resolution through the use of psychoactive drugs.However, it should be questioned about the scientific foundations who claim a high andbelief so high prevalence for this pathology, reaching almost, in some cases, 20 per cent.Alternatively, if it is possible to hold to the TDHA as an independent diagnosed entity, orif it is only a relatively independent symptoms set with each other
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/classificação , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtorno do Deficit de Atenção com HiperatividadeRESUMO
OBJECTIVE: The validity of a diagnosis of ADHD in children with a high intelligence quotient (IQ) remains controversial. Using a multidisciplinary approach, rigorous diagnostic criteria, and worldwide-validated psychometric instruments, we identified a group of children attending public schools in southern Brazil for co-occurrence of high IQ and ADHD. METHOD: Students attending public schools, in the first to fifth grades, were referred to our Research Center for behavioral and/or learning difficulties. These children completed clinical, psychiatric, psychological, and pedagogical evaluations for assessment of IQ, ADHD, learning, and other emotional or behavioral disorders. RESULTS: Fifteen of the participants were identified to have a full-scale IQ ≥ 120. Data show that 10 of these high-IQ children met the DSM-IV criteria diagnosis for ADHD combined type, 5 met criteria for current oppositional-defiant disorder, 2 had current major depression, and 2 had a learning disorder. Here we present the results as a case series. CONCLUSION: Our data support the hypothesis that ADHD is a valid diagnosis in children with high IQs.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtorno Depressivo/diagnóstico , Inteligência , Deficiências da Aprendizagem/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Brasil , Criança , Transtorno Depressivo/complicações , Transtorno Depressivo/psicologia , Humanos , Testes de Inteligência , Deficiências da Aprendizagem/complicações , Deficiências da Aprendizagem/psicologia , Masculino , Psicometria , Reprodutibilidade dos TestesRESUMO
The objective of the current study was to evaluate a proposed restrictive inattentive type of Attention Deficit Hyperactivity Disorder (ADHD) by comparing clinical correlates among youths with ADHD inattentive type (ADHD-I) as a function of the number of hyperactivity symptoms presented (none vs. 3 or less) and controls (individuals without ADHD). The sample for this community-based study was comprised of youths aged 6 to 18 years from 12 public schools in Porto Alegre, Brazil. ADHD-I groups had lower levels of adaptive functioning (p < .001) and a higher occurrence of familial ADHD (p < .001) when compared with the controls. There was no significant difference between the two ADHD-I groups. Also, both ADHD-I groups had higher rates of oppositional defiant disorder than controls (p < .001) without significant difference between them. For generalized anxiety disorder and social phobia, only the ADHD-I without HI group showed significant differences compared to controls.
Assuntos
Adaptação Psicológica , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/classificação , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Família/psicologia , Agitação Psicomotora/diagnóstico , Adolescente , Transtornos de Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/classificação , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Brasil/epidemiologia , Criança , Comorbidade , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Transtornos Fóbicos/diagnóstico , Transtornos Fóbicos/epidemiologia , Agitação Psicomotora/psicologia , Estudos de AmostragemRESUMO
The main goal of this study is to determine the degree of agreement between the reports provided by parents and teachers about oppositional defiant symptoms in school children between the ages of 6 and 8 years. In addition, it attempts to determine whether children's age and sex affect the level of agreement between informants. Parents and teachers assessed 702 girls and boys at 25 schools in the Region of Osona, Barcelona (Spain) with the Child Symptom Inventory-4 (parents' and teachers' version). The results indicate a very low agreement -practically null- between the valuations of both informants; furthermore, no significant difference due to the variables age and sex of the children was observed in the above-mentioned valuations. The parents tended to appraise most of the symptoms of the Oppositional Defiant Disorder as present and to evaluate their severity as being more intense.
Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Docentes , Pais , Criança , Feminino , Humanos , MasculinoRESUMO
OBJECTIVE: To estimate the prevalence of psychiatric disorders in preadolescents aged 11-12 years from a birth cohort in a southern Brazilian city. METHODS: This is a cross-sectional investigation nested in a cohort study with a two-phase design: screening and diagnosis. In the screening phase, 4,452 preadolescents and their mothers were interviewed with the Strengths and Difficulties Questionnaire (SDQ). In the diagnostic phase, all preadolescents with a positive SDQ (n = 122) and their mothers answered the Development and Well-Being Assessment for Children and Adolescents (DAWBA). A sample randomly selected among the cohort participants with a negative SDQ served as a control group (158 subjects and their mothers) and was also assessed using the DAWBA. RESULTS: After adjustment for the performance of the screening instrument, 10.8% (95% CI 7.1-14.5) of the preadolescents showed at least one psychiatric disorder according to either the DSM-IV or the ICD-10. The most prevalent disorders were disruptive behavior (prevalence rates were 8.5% according to the DSM-IV and 7.1% according to the ICD-10) and anxiety disorders (prevalence rates were 6.0% according to the DSM-IV and 6.2% according to the ICD-10). CONCLUSION: Both overall and individual prevalence rates of psychiatric disorders found in this study are in the same range of other international studies, although slightly higher than findings from developed countries. The results corroborate previous findings from other epidemiological studies in children and adolescents suggesting the universality of psychiatric disorders across cultures.