RESUMO
OBJECTIVE: To examine the validity of sluggish cognitive tempo (SCT) and ADHD-inattention (ADHD-IN) symptoms in children from Chile. METHOD: Mothers and teachers rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (ADHD-HI), oppositional defiant disorder (ODD), anxiety, depression, academic impairment, social impairment, and peer rejection (teachers only) in 652 Chilean children (55% boys) aged 6 to 14 years. RESULTS: For both mother and teacher ratings, the eight SCT symptoms and nine ADHD-IN symptoms showed substantial loadings on their respective factors (convergent validity) along with loadings close to zero on the alternative factor (discriminant validity). ADHD-IN showed a uniquely stronger relationship than SCT with ADHD-HI and ODD whereas SCT showed a uniquely stronger relationship than ADHD-IN with anxiety and depression. Although ADHD-IN uniquely predicted academic impairment and social difficulties, SCT did not. CONCLUSION: This study provides the first evidence for the validity of SCT among children outside of North America or Western Europe.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos Cognitivos/psicologia , Fracasso Acadêmico , Desempenho Acadêmico/etnologia , Adolescente , Transtornos de Ansiedade/etnologia , Transtornos de Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/etnologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/etnologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Criança , Chile/etnologia , Transtornos Cognitivos/etnologia , Transtorno Depressivo/etnologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Comportamento Impulsivo , Relações Interpessoais , Masculino , Mães , Grupo Associado , Professores EscolaresRESUMO
To explore behavioral differences as possible cultural factors in presentation of psychiatric comorbidity in two clinically referred, consecutively ascertained samples of youth with Tourette's disorder (TD) from New York and Buenos Aires. Subjects were evaluated between 2002 and 2010 at the Tics and Tourette's Clinical and Research Program at the New York University Child Study Center in New York and the Interdisciplinary Center for Tourette's, Obsessive Compulsive Disorder (OCD) and Associated Disorders (CITTTA)/Institute of Cognitive Psychology (INECO) in Buenos Aires. Demographic, diagnostic, tic severity (Yale Global Tic Severity Scale; YGTSS), clinical (Child Behavior Check List-Parent version; CBCL), and global functioning (Global Assessment of Functioning; GAF) data were compared using descriptive statistics. The sample included 111 subjects ages 6-17 years, who met DSM-IV-TR diagnostic criteria for TD. Findings revealed that the BA sample (n = 35) was significantly older at initial evaluation at the tic specialty clinic, and had higher frequency of oppositional defiant disorder (ODD), mood and non-OCD anxiety disorders than the NY sample (n = 76). There were no differences in gender distribution, age at tic onset or TD diagnosis, tic severity, proportion with current diagnoses of OCD/OC behavior or attention deficit hyperactivity disorder (ADHD), CBCL internalizing, externalizing, or total problems scores, YGTSS scores, or GAF scores. The observed similarities in demographic features, clinical presentation, rates of ADHD and OCD/OCB, and global impairment may reflect similar phenomenology and illness-related characteristics of TD in these referred youth. Differences in age at initial specialty clinic evaluation and rates of ODD, mood and non-OCD anxiety disorders may need further exploration before they may be considered to reflect cultural factors. Because of these limitations (e.g. small sample size), these results can be regarded only as preliminary.
Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/etnologia , Transtorno Obsessivo-Compulsivo/etnologia , Transtornos de Tique/diagnóstico , Síndrome de Tourette/diagnóstico , Síndrome de Tourette/etnologia , Adolescente , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Argentina/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Criança , Comorbidade , Comparação Transcultural , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/psicologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Transtornos de Tique/epidemiologia , Síndrome de Tourette/psicologia , Estados Unidos/epidemiologiaRESUMO
The present study assesses the population prevalence of DSM-IV disorders among native and immigrant children living in low socio-economic status (SES) inner-city neighborhoods in the Netherlands. In the first phase of a two-phase epidemiological design, teachers screened an ethnically diverse sample of 2041 children aged 6-10 years using the Strengths and Difficulties Questionnaire (SDQ). In the second phase, a subsample of 253 children was psychiatrically examined, while their parents were interviewed. In addition, teachers completed a short questionnaire about 10 DSM-IV items. Prevalence was estimated using the best-estimate diagnosis based on parent, child and teacher information. Projected to the total population, 11% of the children had one or more impairing psychiatric disorders, which did not differ between native and non-native children. In the total group a clear relationship was observed between the prevalence of psychiatric disorders and gender, parental psychopathology, peer problems and school problems, but not among all ethnic groups separately. This study suggests that the prevalence of psychiatric disorders among non-treated minority and native children in low SES inner-city neighborhoods does not materially differ. However, associated mechanisms may be influenced by ethnicity.
Assuntos
Emigração e Imigração , Etnicidade/psicologia , Transtornos Mentais/etnologia , População Urbana/estatística & dados numéricos , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etnologia , Ansiedade de Separação/diagnóstico , Ansiedade de Separação/epidemiologia , Ansiedade de Separação/etnologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/etnologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/etnologia , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/etnologia , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etnologia , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/etnologia , Comparação Transcultural , Estudos Transversais , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/etnologia , Emigração e Imigração/estatística & dados numéricos , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Controle Interno-Externo , Masculino , Programas de Rastreamento , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Marrocos/etnologia , Países Baixos , Determinação da Personalidade , Fatores Socioeconômicos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etnologia , Suriname/etnologia , Turquia/etnologiaRESUMO
OBJECTIVE: Eighteen extended multigenerational families were recruited from the genetically isolated Paisa community in Colombia to conduct genetic studies of attention-deficit/hyperactivity disorder (ADHD). This report describes the inclusion strategy and clinical features of participants to facilitate comparisons with other data sets. METHOD: Families were selected through a fixed-sampling scheme beginning with child probands referred for clinical evaluation for ADHD. Direct structured psychiatric interviews were conducted with 433 informative individuals, including 92 children aged 4 to 11, 57 adolescents aged 12 to 17, and 284 adults. Best estimate ADHD diagnoses were established for each informative pedigree member. RESULTS: These families contained a high proportion of individuals affected with ADHD (32.8%), which was highly comorbid with conduct disorder (50%; odds ratio 11.5, 95% confidence interval = 6.4-20.9), oppositional defiant disorder (25.4%; odds ratio 2.7, confidence interval = 1.5-4.8), and associated conditions including nicotine dependence and alcohol abuse and/or dependence. CONCLUSIONS: ADHD in these extended Paisa families is highly comorbid with conduct and oppositional defiant disorders. This pattern of comorbidity, as well as the large dense pedigrees of the sample, suggests that it will be particularly useful for molecular genetic studies that are currently under way.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etnologia , Transtorno do Deficit de Atenção com Hiperatividade/genética , Relação entre Gerações , Idoso , Alcoolismo/diagnóstico , Alcoolismo/etnologia , Alcoolismo/genética , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/etnologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/genética , Área Programática de Saúde , Colômbia/epidemiologia , Comorbidade , Humanos , Masculino , Pessoa de Meia-Idade , Linhagem , Estudos de Amostragem , Tabagismo/diagnóstico , Tabagismo/etnologia , Tabagismo/genéticaRESUMO
Using data from the MECA Study, this report examines the prevalence of Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), and various levels of antisocial behavior and their correlates among three ethnic groups: Hispanics, subdivided into Island Puerto Ricans and Mainland Hispanics; African Americans; and Mainland Non-Hispanic, Non-African Americans. Correlates considered include stressful life events, birth defects, low birth weight, learning difficulties, teen mothers, family environment, marital adjustment, social competence, parental monitoring, and family relationships. Logistic regression was used to determine the association of outcomes with individual correlates and of interaction terms with ethnicity. Differences between adjusted rates and observed rates of disorders and levels of antisocial behaviors are compared to estimate the extent to which each correlate explains the group differences in rates. Island Puerto Ricans had a lower prevalence of CD, ODD, and various levels of antisocial behavior than mainland Hispanics, African Americans, and non-Hispanic Whites. The lower prevalence appears to be associated with differences in the extent to which a number of these correlates are found on the island, the most salient being better family relations between the target children and their parents and siblings.