IS ADHD UNDER-DIAGNOSED IN BOSNIA AND HERZEGOVINA? COMPARISON OF CLINICALLY CONFIRMED CASES VS. PARENT-REPORTED PREVALENCE OF ADHD

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is a frequent neurodevelopmental disorder characterized by hyperactivity, inattention, and impul- sivity. The issue of whether ADHD is a socially constructed disorder has received much attention. The goal of the present study was to examine the clinical prevalence of ADHD in Bosnia and Herzegovina (BIH). An additional goal was to investigate the prevalence of school-aged children who fulfill the criteria for the condition but do not have a clinical diagnosis. For the first research goal, the sample consisted of five University Clinical Centers in BIH that provided data on the prevalence. For the second goal, the sample consisted of 1935 parents of children aged 6 to 15 years. Parents of 1935 school-aged children from the Federation BIH completed the questionnaire regarding ADHD symptoms. Children ranged in age from 6 to 15 years. The mean age of children was 10.2 years (SD- 2.1 years). There were 1061 girls and 874 boys in the sample. Five hospitals in the Federation BIH (4 University Clinical Centers and 1 Cantonal Hos- pital) were sent a questionnaire to provide us with information on how many school-aged children were diagnosed with ADHD and their basic demographic data. In addition, the Clinical Centers were asked to provide information on what treatment they provide to children with ADHD. The results of this study indicated that clinical diagnosis of ADHD is infrequent. The number of clinically confirmed cases of ADHD in the Federation BIH was 138 or less than 0.001%. On the other hand, accord ing to survey data, there is a prevalence rate of ADHD indicated like that observed in western countries. According to the parents’ reports, there were 97 children or 5% who fulfilled the criteria for ADHD diagnosis. In relation to gender distribution of ADHD, there were more boys (88 boys) than girls (50 girls) with a clinically confirmed diagnosis of ADHD and boys were 1.76 times more likely to have a ADHD diagnosis than were girls. On the other hand there were more girls than boys who had ADHD according to parents’ reports, but this difference, according to the Chi square test, was not statistically significant (ꭓ 2 = 0.14; p = ,70). The results of this study have clearly shown that ADHD is underdiag- nozed in Bosnia and Herzegovina. There is a huge discrepancy between the clinically diagnosed children and the parent-reported symptoms of ADHD. Given the burden that ADHD has on children and their families it should be of the utmost importance to provide timely diagnosis and proper treatment. One way to improve the current situation is through a better cooperation between school staff (psychologists, teachers), parents, and medical professionals.