ADHD is reported as a frequent comorbidity in pediatric epilepsy. We aimed to clarify the prevalence of ADHD, its neurological correlates and the role of ADHD in health-related quality of life (HRQOL) in children with severe epilepsy.
Data from the ADHD Rating Scale-IV (ADHD-RS-IV) from 203 children (mean age = 11.8, SD=3.8) from a tertiary center serving children with severe epilepsy were reviewed.
Inattention was frequently elevated in the sample (40% vs. 18% for hyperactivity-impulsivity). Age of onset, epilepsy duration, and seizure frequency were not related to severity of inattention or hyperactivity-impulsivity. Over 60% of children met screening criteria for ADHD-Inattentive subtype (ADHD-I) or ADHD-Combined Inattentive/Hyperactive-Impulsive subtype (ADHD-C). Compared to ADHD-I, ADHD-C was associated with earlier onset of seizures, generalized epilepsy, lower adaptive level, and in normally developing children, a higher degree of intractability compared to ADHD-I. ADHD-I was more prevalent in localization-related epilepsy, and there was a trend for a higher use of AEDs with cognitive side effects in this group. ADHD was associated with poor HRQOL: children with ADHD-I and ADHD-C had a two- and four-fold likelihood of low HRQOL, respectively, compared to non-ADHD children.
Children seen at tertiary care centers for severe epilepsy are at high risk for attention problems and ADHD, and ADHD is a significant predictor of poor HRQOL in epilepsy, particularly in the case of ADHD-C. ADHD occurring in the context of severe epilepsy appears to be associated with specific neurological characteristics, which has implications for comorbidity models of ADHD and epilepsy.
The aim was to examine associations of age and gender with ADHD subtypes and subsequently to examine associations of age, gender, and subtypes with comorbid psychiatric disorders.
Odds ratios were calculated and logistic regression performed using information from a clinical sample of 155 ADHD adults referred to a Danish specialized ADHD unit from 2010 to 2011.
A majority of men (65%) was found in the sample. Most patients were subtyped ADHD combined (78%), followed by ADHD inattentive (18%), and ADHD hyperactive-impulsive (4%). No significant differences were found in gender and age across subtypes. Current comorbid disorders were found in 57% of the ADHD patients. Significantly more comorbidity was found in the ADHD combined type and in patients =25 years. Significantly more men had substance use disorders and significantly more women had personality disorders.
When assessing adult ADHD patients' age, gender, subtype, and related comorbid symptom profiles should be taken into account.
A population study of 409 seven-year-old children in a middle-sized Swedish town was performed. All children were examined by the same doctor and evaluated by means of parent interview, motor examinations, and teacher reports on behaviour in the classroom. Follow-up was carried out 8 months later. The rate of severe problems in the fields of attention deficit-hyperactivity disorder (ADHD), developmental coordination disorder (DCD), and deficits in attention, motor control, and perception (DAMP) (the combination of ADHD and DCD) was 6.1%, with boys being affected more frequently than girls. There was considerable overlap between ADHD and DCD, with about half of each diagnostic group also meeting criteria for the other diagnosis. Attention deficits at diagnosis strongly predicted attention deficits at follow-up. If parents had noted attention deficits in the home setting, then teachers almost always independently agreed that there were similar problems in the classroom. However, the reverse did not always apply. Clumsiness also showed striking stability over time. The diagnosis of DAMP, particularly severe DAMP, had a stronger association with classroom dysfunction and with high Conners scores than did diagnoses of ADHD or DCD. It is concluded that DAMP may be a clinically valid diagnostic construct.
OBJECTIVE: This study explores the comorbidity between symptoms of ADHD and PTSD in relation to IQ among refugee children of traumatized parents (TP) and non-traumatized parents (NTP). METHOD: The study compares 80 refugee children, 40 with TP with 40 with NTP. ADHD and PTSD are assessed using DICA. Children's cognitive functions are measured by WISC. Teacher ratings of YCI and SDQ are performed. RESULTS: Overlapping between ADHD and PTSD symptoms are represented among children with TP. Cognitive functions, related to ADHD and PTSD, reveal associations between low IQ (
INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity and impulsivity. The diagnostic classification is based on developmental anamnesis, objective examination, neuropsychological tests, observation of the child, and evaluation of the symptoms from rating scales. MATERIAL AND METHODS: The internationally known ADHD rating scale (ADHD-RS) has been translated into Danish and representative norm data from teachers and parents were collected. A total of 1,718 ADHR-RS questionnaires were distributed to 859 anonymous school children, aged 6-17 years, and a total of 1,477 ADHD-RS questionnaires were returned. Analyses were made on 781 children, 420 boys and 361 girls. RESULTS: The average participation rate was 99.5% for teachers and 72.4% for parents. The factor structure was supported and internal consistency was high. The normative scores were calculated for both girls and boys in three age-groups, for parent answers and teacher answers separately. CONCLUSION: There were significant variations in ratings of ADHD and behavioural symptoms as a function of gender and age. It is crucial, during an evaluation of a child, to compare his or her scores to gender- and age-stratified normative data. Standardized normative ADHD-RS data from school children is now available and can be implemented in a national quality database within child and adolescent mental health services. The questionnaire can support the diagnostic classification, measure symptom-load and evaluate outcome of treatment of ADHD.
Attention-deficit hyperactivity disorder (ADHD) in adults is a phenomenon that attracts a lot of attention in society today. Advances in research have made it clear that many conditions that make people seek medical and psychiatric care may have pervasive deficits in attention, motor control and impulsivity at their roots. Since ADHD in adults is a relatively new and very versatile concept, there is a great need for systemized classification of the ramifications of the deficit that extends into every aspect of these patients' lives.
To develop a Swedish Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for adult patients with ADHD.
A national expert survey was conducted using the Delphi technique and a formal consensus conference. Forty-two experts from different professions and organizations, including psychiatrists and physicians, psychologists, occupational therapists, a counsellor, a specialist nurse, representatives from a patient organization and representatives from the Swedish Social Insurance Agency, participated in the Delphi process and 28 participants from the expert group attended the consensus conference.
At the formal consensus conference, 66 categories from the ICF were identified and included in the national Comprehensive Core Set for ADHD: 21 categories from the component body functions, 26 categories from the component activities and participation, and 19 categories from the component environmental factors.
The Comprehensive Core Set for ADHD should be regarded as national and preliminary, and should be further tested and evaluated by experts in ADHD in clinical settings in Sweden.
Children with attention deficits have been known since the beginning of the last century. Untreated children have a poor prognosis. This paper reviews the diagnostic criteria and the problems there still are with the diagnoses. There are two official diagnostic systems, ICD-10 and DSM-IV, both have descriptive and general diagnostic criteria. There are no independent valid tests, but the last two years have seen recommendations from the USA and UK for a more thorough diagnostic assessment. For the diagnosis of DAMP, as it is used in Sweden, there are no proper scientific studies. More specific criteria are described in a Danish reference programme for children with DAMP.
OBJECTIVE: DSM-IV is the most widely used diagnostic classification system in research, whereas ICD-10 is more widely used clinically. Knowledge of differences is essential when research findings are implemented in daily clinical practice. We examined differences between the two diagnostic systems regarding three major child psychiatric diagnostic categories. METHODS: A total of 199 consecutively referred, child psychiatric patients were interviewed with a semistructured diagnostic interview (K-SADS-PL) including questions covering specific ICD-10-DCR criteria, and diagnosed according to both diagnostic systems. RESULTS: Differences were found regarding the diagnoses major depressive disorder/depressive episode and attention deficit hyperactivity disorder/disturbance of activity and attention. In both cases, more children met DSM-IV-TR criteria than ICD-10-DCR criteria. The diagnosis, oppositional defiant disorder, proved interchangeable between the two diagnostic systems. CONCLUSION: Differences between diagnostic systems must be taken into account when research findings using one diagnostic system are implemented with children diagnosed by another diagnostic system.
To examine whether a bifactor model with a general ADHD factor and domain specific factors of inattention, hyperactivity and impulsivity was supported in a large general population sample of children. We also explored the utility of forming subscales based on the domain-specific factors.
Child mental health questionnaires were completed by both teachers and parents of all children in grades 2-4 in Bergen, Norway. Confirmatory factor analysis was performed on the ADHD items of a modified version of the Swanson, Nolan and Pelham Questionnaire-IV (SNAP-IV) for 6,237 children.
The bifactor model showed very good model fit with a strong general ADHD factor and specific factors for impulsivity and inattention. The subfactors, especially hyperactivity, generated from the SNAP-IV ADHD items conveyed little unique variance in the model.
The findings in this general population sample with a strong general ADHD factor in the bifactor model supports the view on ADHD as a unitary concept with specific domain factors for inattention and impulsivity, but not for hyperactivity. The bifactor model questions the utility of constructing ADHD subscales by the use of a simple sum score when using the SNAP-IV.