Suggestive diagnosis of attention-deficit/hyperactivity disorder in indigenous children and adolescents from the Brazilian Amazon

Paulo Verlaine Borges E Azevêdo,Leonardo Ferreira Caixeta,Daniela Londe Rabelo Taveira,Margareth Rocha Peixoto Giglio,Luis Augusto Rohde,Maria Conceição Do Rosário

doi:10.1007/s00787-019-01356-y

Abstract

The prevalence of attention-deficit/hyperactivity disorder (ADHD) symptoms has been scarcely studied in indigenous cultures that preserve ancestral cultural characteristics. The objective of the study is to estimate the prevalence of suggestive diagnosis of ADHD among indigenous children and adolescents from villages in the Amazon. This is an analytical cross-sectional study using instruments to track ADHD symptoms (the Child Behaviour Checklist for ages 6–18: CBCL/6–18 and the teacher report form for ages 6–18: TRF/6–18) and to investigate their negative impact on the patients (using the Strengths and Difficulties Questionnaire—SDQ). The prevalence of a suggestive ADHD diagnosis according to the CBCL/TRF DSM-IV ADHD subscale without and with negative impact as assessed by the SDQ was 4.3% and 1.1%, respectively. Comorbid oppositional-defiant, conduct problems and anxious symptoms were present in all cases screening positive for ADHD. We also presented a case report as an illustration of the observed clinical presentation. ADHD is a recognizable disorder even in a culture that preserves millennial characteristics. Furthermore, the presence of ADHD symptoms was associated with significant impairment.

Highlights

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder, characterized by the presence of inattentive and/or hyperactive/impulsive symptoms disproportionate to the developmental stage, causing functional impairment in more than one environment [1, 2]
We investigated the prevalence of ADHD symptoms in a population of indigenous village children and adolescents
We studied the prevalence of signs and symptoms indicative of ADHD, motivated by the demand of the indigenous community itself

Summary

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder, characterized by the presence of inattentive and/or hyperactive/impulsive symptoms disproportionate to the developmental stage, causing functional impairment in more than one environment [1, 2]. It afflicts approximately 5% of children and adolescents [3, 4] and 2.5% [1] to 4.4% [5] of adults. Despite having a well-established diagnosis and treatment, there are still discussions about its cross-cultural validity [6, 7] It is questioned whether differences in worldwide prevalence would reflect changes in the incidence or tolerance of different societies to inappropriate behaviours [8]. There are few published studies on ADHD in these populations, some previous reports can be found in the United States [9,10,11],

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Conclusion