Prevalence Of Attention Deficit Hyperactivity Disorder In Children Research Articles

Attention-deficit/hyperactivity disorder in children with epilepsy: A systematic review and meta-analysis of prevalence and risk factors.

To evaluate the prevalence of and risk factors for attention-deficit/hyperactivity disorder (ADHD) in children with epilepsy (CWE). We conducted a systematic search in PubMed and Embase for the meta-analysis. The pooled prevalence of ADHD was calculated using a random-effects model; subgroup analyses were performed to explore heterogeneity. We collected raw data from articles reporting potential risk factors, which were included in the subsequent risk factor analysis. Forty-six articles met the inclusion criteria for the meta-analysis, which showed a pooled ADHD prevalence of 30.7% in CWE, with a predominance of the inattentive subtype of ADHD; the heterogeneity of prevalence was related to population source/study setting (clinic based, community based, or database based) and method of ADHD diagnosis (with or without clinical review). Risk factors for ADHD in epilepsy included younger age, intellectual/developmental disabilities, a family history of epilepsy, earlier epilepsy onset, absence epilepsy, more frequent seizures, and polytherapy; In contrast, risk factors such as sex, generalized epilepsy or seizures, epilepsy etiology, and electroencephalogram abnormalities were not significantly associated with the occurrence of ADHD. The prevalence of ADHD in CWE is high and several potential risk factors are associated with it. This study contributes to a better understanding of ADHD in epilepsy for screening and treatment. This systematic review summarizes the prevalence of attention-deficit/hyperactivity disorder (ADHD) occurring in children with epilepsy and analyses the risk factors for comorbid ADHD in epilepsy. By reviewing 46 articles, we concluded that the overall prevalence of ADHD in children with epilepsy was 30.7% and that intellectual/developmental disabilities were the most significant risk factor for combined ADHD in children with epilepsy. This study provides a wealth of information on comorbid ADHD in epilepsy, which will help clinicians identify and treat potential ADHD in children with epilepsy in a timely manner.

Rising Trends of Childhood Attention-Deficit/Hyperactivity Disorder in a Large Integrated Healthcare Delivery System in Southern California, 2010-2021

ObjectiveTo evaluate trends of attention-deficit/hyperactivity disorder (ADHD) diagnosis rates among children aged 5-17 years over the past decade (2010-2021) and to investigate whether there have been differences in temporal changes based on race and ethnicity, sex, or income Study designChildhood ADHD diagnosis was ascertained from electronic health records using ICD-9 (314.xx) and ICD-10 (F90.x) codes. Data were stratified by child’s sex, race and ethnicity, and household income, and rates of ADHD were estimated before and after adjustment for potential confounders. ResultsThe overall ADHD diagnosis rates increased from 3.5% in 2010 to 4.0% in 2021. ADHD diagnosis was most prevalent among White children (6.1%), then Black (4.6%), Other/multiple (3.7%), Hispanic (3.1%), and Asian/Pacific Islander (PI) (1.7%). ADHD was also highly prevalent among boys (73.3%) or family income≥$70,000 (50.0%). ADHD diagnosis increased among Black (4.2% to 5.1%), Hispanic (2.8% to 3.6%) ,and Asian/PI children (1.5% to 2.0%) but remained stable for White (6.2% to 6.1%) and Other/multiple race/ethnic children (3.7% to 3.7%). Increases in the prevalence among girls were also observed. ConclusionThe prevalence of ADHD in children has risen with the largest increases observed for Black, Hispanic, and Asian/PI children. Rates among less affluent families and girls have also been increasing, narrowing the gaps in diagnosis rates previously observed. These increases may reflect improvements in screening and provision of care among demographics where ADHD has been historically underdiagnosed.

Prevalence of Attention Deficit Hyperactivity Disorder in Girls With Central Precocious Puberty

Objective: The purpose of the current study was to examine the prevalence of attention deficit hyperactivity disorder (ADHD) in girls with central precocious puberty. Method: Girls with central precocious puberty were prospectively recruited from the pediatric clinic. Screening was done with ADHD Rating Scale (ADHD-RS) and Child Behavior Checklist (CBCL). Those who screened positive on ADHD-RS were referred for the diagnostic evaluation which included a Computerized Performance Test (CPT) and a clinical interview conducted by a child adolescent psychiatrist. Results: Among the 81 girls (mean age = 8.97 ± 0.91) who completed the study, 11 girls (13.58%) were diagnosed with ADHD: 5 of them were inattentive type and 6 of them were combined type. Conclusion: The present exploratory study showed that the prevalence of ADHD in girls with central precocious was higher than the known worldwide prevalence of ADHD in children

The global prevalence of ADHD in children and adolescents: a systematic review and meta-analysis

BackgroundAttention-Deficit / Hyperactivity Disorder is a developmental neurological disorder that has three basic characteristics: Attention Deficit, Hyperactivity, and impulsivity. This study aimed to investigate the prevalence of ADHD in children and adolescents.MethodsThis investigation was carried out using the meta-analysis method under PRISMA guidelines. Until October 2020, the articles were gathered by scanning PubMed, Scopus, WOS, and Science Direct databases. The second version of Comprehensive Meta-Analysis software was used to run analyses after extracting data from chosen papers. At a significance level of 0.05, the I2 test was used to analyze study heterogeneity, and the Egger test was used to assess publication bias.ResultsThis analysis includes 61 cross-sectional research, with 53 research used to determine the prevalence of ADHD in children, 7.6% of 96,907 children aged 3 to 12 years had ADHD (95% confidence interval: 6.1–9.4%), and 5.6% of teenagers aged 12 to 18 years have ADHD (95% confidence interval: 4.8-7%). The prevalence of ADHD in children and adolescents according to the DSM-V criterion is also higher than previous diagnostic criteria, according to studies.ConclusionThe findings of this study based on meta-analysis show the high prevalence of attention deficit hyperactivity disorder (ADHD). The findings of this study demonstrate the importance of management and policy in the treatment and control of ADHD in children and adolescents.

The health economic potential of harnessing placebos in treatment of ADHD

IntroductionPlacebo research investigated the underlying mechanisms of placebo effects, but they are rarely used to optimize treatments. Ethical and legal concerns have been raised, but research demonstrated that placebo mechanisms can be used without patients’ deception: Experimental studies showed that half of drugs in treatment of attention-deficit/hyperactivity disorder (ADHD) combined with open-label placebos could be as effective as standard medication to reduce ADHD symptoms.ObjectivesTo estimate the health economic advantages of harnessing the combination of open-label placebos with standard medication in ADHD.MethodsFor preliminary estimation of the mean treatment costs, the 12-months prevalence of ADHD in children and adolescents aged 5 to 14 years as well as the percentage of medication treatments were extracted from the literature. Mean treatment costs per patient and year were calculated for four treatment plans (different drugs and dosages) with both treatment with standard medication and half of drugs in combination with placebos.ResultsA 12-months prevalence of 4.3% equals around 260,000 children and adolescents with a compulsory health insurance in Germany. Of those, around 40-50% are equally treated with two standard drugs and two different dosages. Full standard drug treatments cost around 119 million EUR, and treatment with half of drugs in combination with placebos cost around 66 million EUR.ConclusionsThe combination of open-label placebos with half of standard medication could considerably reduce health costs. Reduction of side effects still must be considered. However, current studies are of experimental nature and lasted for no longer than two weeks.

Comparing the prevalence of attention deficit hyperactivity disorder in hearing-impaired children with normal-hearing peers

ObjectivesThe most important aspect of hearing loss is its effect on the communication abilities of individuals. The aim of this study was to compare the prevalence of attention deficit hyperactivity disorder (ADHD) in hearing-impaired (HI) children with normal-hearing (NH) peers. MethodsA total of 130 children (65 children with severe-to-profound hearing loss and 65 NH peers) participated in this cross-sectional study from November 2013 to May 2014. ADHD Rating Scale IV questionnaires were given to children's parents to collect data. Descriptive and analytical analyses were used in order to achieve the objectives of the study. ResultsThe mean age of the HI children and NH peers was 14.1 and 13.3 years, respectively. In the case group, 52 children suffered from congenital hearing loss and 10 children had acquired hearing loss. In total, 19 cases (29.2%) and eight controls (12.3%) were diagnosed with ADHD. This difference was statistically significant (P=0.017). The prevalence of ADHD in children with hereditary or acquired hearing loss was 30.7% and 20.0%, respectively. However, this difference was not significant (P=0.71). ConclusionThe prevalence of ADHD in school-aged children with hearing loss is higher than that in the general population of the same age. We could not find significant differences between the different subgroups due to the small sample size. Therefore, we recommend a further larger study to determine the interaction between hearing loss and ADHD.

Attention deficit hyperactivity disorder in childhood and adolescence : Current state of research

Attention deficit hyperactivity disorder (ADHD), defined by the core symptoms impulsiveness, inattention and motor hyperactivity, is one of the most common neurodevelopmental disorders beginning in early childhood. This article reviews the current state of research on the epidemiology, etiology, diagnostics and therapeutic interventions for ADHD in children and adolescents. A selective literature search was carried out in PubMed with reference to the German S3 clinical guidelines on ADHD in children, adolescents and adults. The epidemiological prevalence of ADHD in children is estimated to be 5.3%. The etiology is complex and heterogeneous and ahigh percentage of the phenotypic variance can be explained by genetic influences. The challenge of ADHD diagnostics is to exclude differential diagnoses while simultaneously identifying common coexisting psychiatric conditions. Treatment recommendations depend on the severity of symptoms. In severe ADHD pharmacotherapy should be considered as the first line intervention. Psychostimulants (various methylphenidate and amphetamine preparations) and the non-stimulants atomoxetine and guanfacine are approved in Germany for treatment of ADHD in children and adolescents. In milder cases as well as in preschool children, psychosocial interventions (including behavioral psychotherapy) are often sufficient.

Effects of Exercise on Cognitive Performance in Children and Adolescents with ADHD: Potential Mechanisms and Evidence-based Recommendations.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder with a complex symptomatology, and core symptoms as well as functional impairment often persist into adulthood. Recent investigations estimate the worldwide prevalence of ADHD in children and adolescents to be ~7%, which is a substantial increase compared to a decade ago. Conventional treatment most often includes pharmacotherapy with central nervous stimulants, but the number of non-responders and adverse effects call for treatment alternatives. Exercise has been suggested as a safe and low-cost adjunctive therapy for ADHD and is reported to be accompanied by positive effects on several aspects of cognitive functions in the general child population. Here we review existing evidence that exercise affects cognitive functions in children with and without ADHD and present likely neurophysiological mechanisms of action. We find well-described associations between physical activity and ADHD, as well as causal evidence in the form of small to moderate beneficial effects following acute aerobic exercise on executive functions in children with ADHD. Despite large heterogeneity, meta-analyses find small positive effects of exercise in population-based control (PBC) children, and our extracted effect sizes from long-term interventions suggest consistent positive effects in children and adolescents with ADHD. Paucity of studies probing the effect of different exercise parameters impedes finite conclusions in this regard. Large-scale clinical trials with appropriately timed exercise are needed. In summary, the existing preliminary evidence suggests that exercise can improve cognitive performance intimately linked to ADHD presentations in children with and without an ADHD diagnosis. Based on the findings from both PBC and ADHD children, we cautiously provide recommendations for parameters of exercise.

The Association between Attention-Deficit/Hyperactivity Disorder and Atopic Dermatitis: A Study among Iranian Children.

Background:The co-occurrence of attention-deficit/hyperactivity disorder (ADHD) with atopic dermatitis (AD) has been well described in some recent association studies; however, we did not have any perspective on this relationship in our country.Aim and Objective:Hence, the present study aimed to assess the prevalence of ADHD in children with AD.Materials and Methods:This cross-sectional study was performed on 95 consecutive children and adolescents (aged 4–18 years) who were referred to dermatology clinics at the two hospitals in Tehran during 2017 with atopic dermatitis. The evidence of atopy was assessed using the 2003 National Survey of Children's Health. The diagnosis of ADHD was based on the Conner Rating Scale. The sleep disorder was also assessed by the Pittsburg sleep quality questionnaire.Results:The prevalence of hyperactivity and attention deficit in our AD patients was 20.0% and 29.47%, respectively. Furthermore, patients with sleep problem were significantly more likely to have hyperactivity disorder (odds ratio [OR]: 2.91, 95% confidence interval [CI]: 1.04–8.16, P = 0.04). According to the results of multiple logistic regression analyses, flexor involvement was the only predictor of hyperactivity disorder in the final model. The univariate and multivariate analyses showed that having attention deficit was associated with having cheek involvement (OR = 3.63, 95% CI: 1.44–9.14, P = 0.01) and sleep problem (OR = 3.68, 95% CI: 1.45–9.33, P = 0.01).Conclusion:It seems that neurocognitive disturbances due to sleep restriction in AD children may be one of the main trigger, especially for attention deficit.

Prevalence of attention deficit hyperactivity disorder and other psychiatric morbidity in children with burn injuries

Background: Several past studies have suggested that attention deficit hyperactivity disorder (ADHD) is a risk factor for paediatric burn injuries while some have concluded that it is protective. The association has not been adequately studied in the Sri Lankan setting. Objectives: To estimate the prevalence of ADHD and other psychiatric morbidity in children presenting with burn injuries and to compare the demographic, burn injury characteristics and past history between the children with and without ADHD. Method: A descriptive case control study was carried out in a paediatric tertiary care hospital in Sri Lanka. The sample comprised all consecutive admissions to the burns unit, in the age range of 4 to 12 years. Swanson, Nolan and Pelham version IV (SNAP IV) was used to diagnose ADHD. Sinhala translation of the Child Behaviour Check List (CBCL) was used to assess psychiatric morbidity. Results: Sample was 183. Prevalence of ADHD in children with burn injuries was 14.2% (n=26). Of the 26 children diagnosed with ADHD, 6 (23%) presented with burn injury or had a past history of burn injury. This was statistically significant (p Conclusions: Prevalence of ADHD among children with burn injuries in this study was 14.2%. Children with ADHD admitted for burn injuries had a higher risk of having past history of injuries than children without ADHD. Sri Lanka Journal of Child Health, 2018; 47(4): 326-331

Attention deficit hyperactivity disorder: concomitant diseases with an emphasis on epilepsy

Attention deficit hyperactivity disorder (ADHD) is the most common cause of behavioral disorders and learning difficulties in preschool and school-age children. Patients with ADHD are often diagnosed with concomitant diseases, which creates additional diagnostic and therapeutic challenges and leads to a more significant reduction in the quality of life. ADHD is often associated with epilepsy: ADHD manifestations are more common in individuals with epilepsy, and vice versa, patients with ADHD are more likely to have epilepsy. The estimated prevalence of ADHD in children is 7–9 %, whereas in children with epilepsy, it reaches 20–50 %. Epilepsy is also one of the most common diseases in children (affecting approximately 1 % of the pediatric population), which is often aggravated by concomitant diseases, including cognitive, behavioral and emotional disorders. Various factors, such as characteristics of epileptic process and lesions in particular portions of the brain, can underlie the development of ADHD in epilepsy. Epileptiform activity and adverse effects of antiepileptic drugs can also play an important etiological role. Some antiepileptic drugs (such as barbiturates) may cause symptoms similar to those in ADHD (in this case, inattentiveness and hyperactivity shall be considered as adverse events that can be reduced or eliminated after cessation of the drug) or exacerbate ADHD symptoms in patients with these disorders. Therefore, the drugs with no negative impact on concomitant diseases or with a positive therapeutic effect for both diseases are preferable in these cases.High prevalence of the ADHD/epilepsy combination leads to a greater reduction in the quality of life, suggesting high relevance of this problem and requiring a revision of therapeutic approaches.

Estudio de prevalencia del trastorno por déficit de atención e hiperactividad en niños en régimen de acogimiento residencial

Introducción. Los niños que se encuentran en régimen de acogimiento residencial constituyen un colectivo de riesgo en el que los problemas médicos pueden alcanzar altas tasas, especialmente aquellos relacionados con la esfera psicológica, donde el trastorno por déficit de atención e hiperactividad (TDAH) es una de las alteraciones del neurodesarrollo más frecuentes. Objetivo. El propósito de este estudio fue determinar la prevalencia de TDAH en los niños de un centro de acogida en Albuñol (Granada) en 2016. Material y Métodos. En este estudio transversal se incluyeron los 106 niños de edades comprendidas entre los 5 y los 17 años del Centro Hogar “Cristo Rey”. La evaluación psicométrica se basó en la Escala de Vanderbilt de TDAH. Las funciones ejecutivas se evaluaron mediante el Behavior Rating Inventory of Executive Function (BRIEF) en aquellos participantes que cumplieron los criterios de Vanderbilt, y también se aplicaron los criterios del DSM-5 en la entrevista clínica para reforzar el diagnóstico de TDAH. Resultados. La prevalencia de TDAH fue del 17.9% en nuestro grupo, siendo el subtipo inatento el más frecuente. Conclusiones. La prevalencia de TDAH en el centro de acogida “Cristo Rey” fue notablemente elevada en comparación con la prevalencia en niños de la población general. Es necesario seguir investigando acerca de las comorbilidades relacionadas con el TDAH en niños en régimen de acogimiento residencial. Deberían instaurarse programas de detección e intervención en centros de acogida por las repercusiones que puede llegar a tener el TDAH.

Attention-Deficit Hyperactivity Disorder in Childhood Epilepsy

Introduction: Attention-Deficit Hyperactivity Disorder (ADHD) is a recognized cause of learning impairment in children. Several studies have shown that there is an increased prevalence of ADHD in children with epilepsy.

The correlation between attention deficit hyperactivity disorder and steroid-dependent nephrotic syndrome.

Nephrotic syndrome (NS) is characterized by nephritic-range proteinuria and the triad of clinical findings associated with large urinary losses of protein, hypoalbuminemia, edema and hyperlipidemia. More than 80% of children below 13 years of age with primary NS have steroid-responsive forms. There is no identifiable cause of attention-deficit hyperactivity disorder (ADHD). It is likely that the symptoms of ADHD represent a final common pathway of diverse causes, including genetic, organic and environmental etiologies. This case-control study was performed on 130 children aged between 5 and 13 years who were followed-up for two years. Sixty-five children with steroid-dependent nephrotic syndrome (SDNS) as the case group and 65 healthy children as the control group were included in the study. Patients with minimal change NS were treated with prednisolone for at least six months. Conner's Parent Rating Scale - 48 (CPRS-48) was completed by the parents and the children were identified with any form of ADHD. Then, children were referred to an expert psychiatrist. The collected data were analyzed with SPSS software. The result showed that there was no significant relationship between different types of ADHD in both groups. Thus, based on current study, one may conclude that there are no significant differences between prevalence of ADHD in children with SDNS and the control group.

Widespread Reductions in Cortical Thickness Following Severe Early-Life Deprivation: A Neurodevelopmental Pathway to Attention-Deficit/Hyperactivity Disorder

Children exposed to early-life psychosocial deprivation associated with institutional rearing are at markedly elevated risk of developing attention-deficit/hyperactivity disorder (ADHD). Neurodevelopmental mechanisms that explain the high prevalence of ADHD in children exposed to institutionalization are unknown. We examined whether abnormalities in cortical thickness and subcortical volume were mechanisms explaining elevations in ADHD among children raised in institutional settings. Data were drawn from the Bucharest Early Intervention Project, a cohort of children raised from early infancy in institutions in Romania (n = 58) and age-matched community control subjects (n = 22). Magnetic resonance imaging data were acquired when children were aged 8 to 10 years, and ADHD symptoms were assessed using the Health and Behavior Questionnaire. Children reared in institutions exhibited widespread reductions in cortical thickness across prefrontal, parietal, and temporal regions relative to community control subjects. No group differences were found in the volume of subcortical structures. Reduced thickness across numerous cortical areas was associated with higher levels of ADHD symptoms. Cortical thickness in lateral orbitofrontal cortex, insula, inferior parietal cortex, precuneus, superior temporal cortex, and lingual gyrus mediated the association of institutionalization with inattention and impulsivity; additionally, supramarginal gyrus thickness mediated the association with inattention and fusiform gyrus thickness mediated the association with impulsivity. Severe early-life deprivation disrupts cortical development resulting in reduced thickness in regions with atypical function during attention tasks in children with ADHD, including the inferior parietal cortex, precuneus, and superior temporal cortex. These reductions in thickness are a neurodevelopmental mechanism explaining elevated ADHD symptoms in children exposed to institutional rearing.

Down Syndrome and Attention-Deficit/Hyperactivity Disorder (ADHD)

Clinicians might minimize the prevalence of behavioral disorders among mentally retarded people. Decreased attention, hyperactivity, and impulsivity are frequently reported in children with Down syndrome, yet the exact prevalence of attention-deficit/hyperactivity disorder (ADHD) has not been clearly estimated in this population. The objective of this study was to estimate the prevalence of ADHD in children with Down syndrome and to emphasize the possible relationship between ADHD symptoms and the level of mental retardation and common medical comorbidity. In this study, the prevalence of ADHD among Down syndrome children was very high, reaching 43.9%. No significant correlation was found between ADHD symptoms and the level of mental retardation, but significant correlation was found with ophthalmologic problems. We conclude that children with Down syndrome are at increased risk for ADHD. When evaluating children with Down syndrome for attention deficits, psychiatric comorbidity as well as medical problems should be carefully taken into consideration.

Treatment of Attention Deficit Hyperactivity Disorder Comorbid with Epilepsy

Pharmacologic treatment approaches for either ADHD (attention deficit hyperactivity disorder) or epilepsy, individually, are well studied. However, very few studies have addressed treatment strategies for children with both conditions. This is unfortunate, as ADHD is the most common psychiatric comorbidity occurring in children with epilepsy (Salpekar & Dunn, 2007). Although the prevalence of ADHD in the general pediatric population ranges from 5–10%, the prevalence of ADHD in children with pediatric epilepsy ranges from 20–38%. The predominantly inattentive subtype is more common (24%) than the combined type (11%) or predominantly hyperactive-impulsive subtype (2%) (Dunn et al., 2003). In some cases, significant distractibility may be identified even before the diagnosis of epilepsy is made (Hesdorffer et al., 2004). Epilepsy is a common illness, affecting nearly 1% of the general pediatric population, and is defined by having two or more unprovoked, afebrile seizures (Davis et al., 2010). The most widely used classification system, developed by the International League Against Epilepsy (ILAE), differentiates epilepsy by etiology and seizure type (Engel, 2006). Specific seizure types are distinguished as either partial or generalized. Partial seizures are identified when the initial clinical or electroencephalographic (EEG) change reflects a focal area of the brain, while generalized seizures are identified where the initial EEG change is widespread throughout the brain. Partial seizures are further classified as simple, if there is no change in consciousness, or complex, if consciousness is altered. Complex partial seizures are frequently associated with auras, five to ten second periods prior to a seizure event, during which an individual may experience physical sensations such as epigastric discomfort, or emotional symptoms such as fear or panic. Seizure episodes or auras may interrupt consciousness, and the result may be apparent distractibility or altered attention. Absence seizures, typically characterized by episodes of 10 seconds or more of staring and altered consciousness, are commonly misdiagnosed as inattention and represent an important differential diagnosis for ADHD (Williams et al., 2002).

Frequency of symptoms of attention deficit and hyperactivity disorder in autistic children

Both DSM-IV and the ICD-10 exclude diagnosis of attention deficit/hyperactivity disorder (ADHD) when autism diagnostic is present. Some authors suggest, however, that autism can be associated to other comorbidity amongst which the ADHD. To estimate prevalence of ADHD in children with autism. Children were selected from a specialized school, all of then had previous diagnosis or diagnostic suspicion of autism. The Brazilian version of the KIDDIE-SADS PL was applied to parents for diagnostic of ADHD. DSM-IV diagnostic of autism was based on parents' interview and child observation. 32 children were included in the study. Results show that 53.1% of the ASD child had ADHD symptoms enough to fulfill DSM-IV diagnostic criteria, whereas 56.9% did not fulfill DSM-IV criteria for ADHD. Results suggest a high frequency of ADHD symptoms in ASD patients. Elucidating if we are facing a comorbity or an autism distinct phenotype can contribute for a more adjusted pharmacotherapy approach for these children.

The Prevalence of Attention Deficit-Hyperactivity Disorder in Children With Nonmonosymptomatic Nocturnal Enuresis: A 4-Year Followup Study

The prevalence of attention deficit-hyperactivity disorder was increased in a predominantly nonmonosymptomatic nocturnal enuresis population reported on previously. At 2 years after onset of treatment for enuresis attention deficit-hyperactivity disorder seemed to be a risk factor for continuing enuresis. In the current 4-year followup study we sought to determine whether the original attention deficit-hyperactivity disorder diagnosis could be reconfirmed, thereby reflecting the presence of a psychiatric syndrome rather than a coping behavior to deal with the negative consequences of enuresis. An additional study goal was to investigate the evolution in enuresis status in children with and without attention deficit-hyperactivity disorder. A total of 79 children diagnosed with enuresis in the baseline study took part in a 3rd screening for attention deficit-hyperactivity disorder. A diagnostic interview (Diagnostic Interview Schedule for Children-Parent Edition) was administered to the parents, questionnaires (Child Behavior Checklist/Teacher Report Form, Disruptive Behavior Disorder Rating Scale) were completed by the parents and teachers, and medical files were consulted. Of the baseline attention deficit-hyperactivity disorder diagnoses 64% could be reconfirmed at 4-year followup, compared to 73% at 2-year followup. The prevalence of enuresis also decreased by 23%, to 42%. The distribution of enuresis at 4-year followup did not significantly differ between children with and without a baseline or final diagnosis of attention deficit-hyperactivity disorder. No significant predictors of bedwetting episodes could be found in sociodemographic, attention deficit-hyperactivity disorder or organic characteristics. At 4-year followup a substantial number of children still met the criteria for attention deficit-hyperactivity disorder, even after becoming dry. The prevalence rate of enuresis decreased much faster than that of attention deficit-hyperactivity disorder, suggesting the presence of a psychiatric syndrome rather than a coping behavior. Contrary to intermediate findings, current enuresis status could no longer be predicted by attention deficit-hyperactivity disorder symptoms.

Prevalence of ADHD in children with velocardiofacial syndrome: A preliminary report

Velocardiofacial syndrome (VCFS) is a relatively common multi-anomaly disorder associated with a deletion on chromosome 22. Patients with VCFS have cardiac anomalies, cleft palate, learning problems, and speech and developmental delays. Previous studies found that mood and psychotic illnesses were the most common psychiatric disorders in patients with VCFS. The few studies that have focused solely on children with VCFS, however, have found an increased prevalence of attention-deficit/ hyperactivity disorder (ADHD). This paper reports on a clinical evaluation and a structured interview that were administered to 52 children with VCFS and their parents. The prevalence of ADHD in this sample was approximately 10 times that in the general population. Awareness of the possibility of increased prevalence of ADHD in VCFS, particularly of the inattentive type, is important because it is likely to be overlooked by parents and clinicians. Intervention with these children may halt the progression of psychiatric illness and improve outcome.