Clinical and functional profile of 6-12-year-old children with attention deficit hyperactivity disorder referred to a tertiary care center in South India
Objective: To describe the clinical, socio-demographic, and functional profile of children with Attention Deficit Hyperactivity Disorder (ADHD) referred to a tertiary care center in Kerala, India.
Methods: A retrospective descriptive study was conducted from records of developmental evaluation clinic over a period of one year. All-consecutive cases the first time diagnosed as ADHD were enrolled. Autism Spectrum Disorder, genetic disorders, and children with sensory impairments were excluded. Clinical profile was based on presenting symptoms, gender, and socio-demographic characteristics; functional status assessed by Conner’s 3 Parent Scale and cognitive status by Intelligence Quotient.
Results: ADHD prevalence in a clinically referred sample was 12.7%. Boy to girl ratio was 6:1. The mean age of presentation was 8.2 years (SD 6.09). The most common presenting symptom was hyperactivity and behavioral problems followed by poor scholastic performance and poor memory. The functional status assessment showed major concerns in all six domains - Inattention, Hyperactivity, Learning Problem, Executive Functioning, Aggression, and Peer relation, in the majority of children. Children presenting with ADHD symptoms at a later age (9-12 years) had lower IQ scores than those diagnosed at a younger age.
Conclusion: Course of childhood ADHD shows a consistent clinical and functional pattern. Early diagnosis and quantification of difficulties at the outset is suggested, which can help in providing early intervention and is likely to improve long-term outcome in these children.
Wolraich M, Brown L, Brown RT, DuPaul G, Earls M, Feldman HM, et al. Subcommittee on Attention Deficit Hyperactivity Disorder; Steering Committee on Quality Improvement and Management. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatr. 2011;128(5):1007-1022. doi: 10.1542/peds.2011-2654.
Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric association. Special ed. New Delhi: CBS Publishers and distributors PVT LTD; 2017:59-65.
Sayal K, Prasad V, Daley D, Ford T, Coghill D. ADHD in children and young people: prevalence, care pathways, and service provision. Lancet Psychiat. 2018;5(2):175-186. doi: 10.1016/S2215-0366(17)30167-0.
Fayyad J, De Graaf R, Kessler R, Alonso J, Angermeyer M, Demyttenaere K, et al. Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry. 2007;190(5):402-409. doi: 10.1192/bjp.bp.106.034389.
Jyothsna A, Anuja S Panicker. Prevalence of attention deficit hyperactivity disorder in primary school children. Indian J Psychiatry. 2013;55(4):338-342. Available from : http://www.indianjpsychiatry.org/article.asp?issn00195545;year2013;volume55;issue4;spage338;epage342;aulasVenkata;aidIndianJPsychiatry_2013_55_4_338_120544.
Biederman J, Mick E, Faraone SV, Braaten E, Doyle A, Spencer T, et al. Influence of gender on attention deficit hyperactivity disorder in children referred to a psychiatric clinic. Am J Psychiatry. 2002;159(1):36-42. doi: 10.1176/appi.ajp.159.1.36.
Tulika S, Sanju S, Seetharamiah N. Socioeconomic status scales updated for 2017. Int J Res Med Sci. 2017;5(7):3264-3267. doi: 10.18203/2320-6012.ijrms20173029.
Russel AE, Ford T, Williams R, Williams R, Russel G. The association between Socioeconomic Disadvantage and Attention Deficit Hyperactivity Disorder: A Systematic Review. Child Psychiatry Hum Dev 2016;47(3):440-458. doi: 10.1007/s10578-015-0578-3.
National Census 2011. Literacy in India. Available from: https://www.census2011.co.in/literacy.php Accessed from internet on 28/12/2018.
Singhi P, Malhi P. Spectrum of Attention deficit hyperactivity disorder in school-aged children. Indian Pediatr. 2000;37(11):1256-1260.
Singh A, Yeh CJ, Verma N, Das AK. Overview of attention deficit hyperactivity disorder in young children. Health Psychol Res. 2015;3(2). doi: 10.4081/hpr.2015.2115.
Faraone SV, Doyle AE, Mick E, Biederman J. Meta-analysis of association between the 7-repeat allele of the dopamine receptor gene and attention deficit hyperactivity disorder. Am J Psychiatry. 200;158(7):1052-1057. doi: 10.1176/appi.ajp.158.7.1052.
Faraone SV, Tsuang MT. Methods in psychiatric genetics: Tohen M, Tsuang MT, Zaner GE, editors. Textbook in psychiatric epidemiology. 2nd ed, New York: John Wiley and Sons; 1995:81-134.
Illingworth’s The Development of the Infant and Young Child: Normal and Abnormal. MKC Nair, Paul Russell, editors. 10th ed; New Delhi: Elsevier Health Sciences; reprinted 2017:139-140.
Owens EB, Hinshaw SP, Lee SS, Lahey BB. Few girls with childhood Attention deficit Hyperactivity disorder show positive adjustment during adolescence. J Clin Child Adolescen Psychol. 2009;38(1):132-143. doi: 10.1080/15374410802575313.
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