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Roigé-Castellví J, Morales-Hidalgo P, Voltas N, Hernández-Martínez C, van Ginkel G, Canals J. Prenatal and perinatal factors associated with ADHD risk in schoolchildren: EPINED epidemiological study. Eur Child Adolesc Psychiatry 2021; 30:347-358. [PMID: 32242248 DOI: 10.1007/s00787-020-01519-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 03/22/2020] [Indexed: 11/29/2022]
Abstract
The aim of this study is to assess the relationship between pre- and perinatal factors and ADHD in a sample of scholars exploring differences between ADHD presentations and spectrum of severity. A total of 6720 scholars (aged 3-4 and 10-11) participated in a double-phase epidemiologic cross-sectional study (Epidemiological Study of Neurodevelopmental Disorders, EPINED), and a sample of 646 scholars (ADHD risk, ASD risk and controls without risk) were individually assessed in the second phase of the study. The ADHD diagnosis, based on DSM-5 criteria, was performed with the Kiddie-Schedule for Affective Disorders & Schizophrenia, Present & Lifetime Version. Associations for the different ADHD presentations between prenatal, perinatal and postnatal factors and ADHD (n = 168), subclinical ADHD (n = 88) and non-ADHD (n = 310) were analysed. Logistic regression models showed that gestational diabetes (p = 0.012), instrumental delivery (p = 0.011), family history of psychopathology (p = 0.033) and maternal ADHD phenotype (p = 0.023) were associated with ADHD. These factors were related to the hyperactive-impulsive and combined presentations, but they were not related to the inattentive presentation. Maternal weight gain was associated with subclinical ADHD. In conclusion, metabolic disorder in the pregnancy, difficulties in childbirth and specific family phenotype were related to ADHD, specifically with hyperactive-impulsive presentation, but not in subclinical ADHD.
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Affiliation(s)
- Joana Roigé-Castellví
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Paula Morales-Hidalgo
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Núria Voltas
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Carmen Hernández-Martínez
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Georgette van Ginkel
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Josefa Canals
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain.
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Caye A, Petresco S, de Barros AJD, Bressan RA, Gadelha A, Gonçalves H, Manfro AG, Matijasevich A, Menezes AMB, Miguel EC, Munhoz TN, Pan PM, Salum GA, Santos IS, Kieling C, Rohde LA. Relative Age and Attention-Deficit/Hyperactivity Disorder: Data From Three Epidemiological Cohorts and a Meta-analysis. J Am Acad Child Adolesc Psychiatry 2020; 59:990-997. [PMID: 31442562 DOI: 10.1016/j.jaac.2019.07.939] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/10/2019] [Accepted: 07/25/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate the effect of relatively younger age on attention-deficit/hyperactivity disorder (ADHD) symptoms and diagnosis through three population-based cohorts and a meta-analysis. METHOD This study included participants of three community-based cohorts in Brazil: 1993 Pelotas Cohort (N = 5,249), 2004 Pelotas Cohort (N = 4,231), and Brazilian High-Risk Study for Psychiatric Disorders (HRC study) (N = 2,511). We analyzed the effect of relatively younger age on ADHD symptoms and diagnosis. For the meta-analysis, we searched MEDLINE, PsycINFO, and Web of Science from inception through December 25, 2018. We selected studies that reported measures of association between relative immaturity and an ADHD diagnosis. We followed the Meta-analysis Of Observational Studies in Epidemiology guidelines. The protocol for meta-analysis is available on PROSPERO (CRD42018099966). RESULTS In the meta-analysis, we identified 1,799 potentially eligible records, from which 25 studies including 8,076,570 subjects (164,049 ADHD cases) were analyzed with their effect estimates. The summarized relative risk of an ADHD diagnosis was 1.34 (95% CI, 1.26-1.43, p < .001) for children born in the first 4 months of the school year (relatively younger). Heterogeneity was high (I2 = 96.7%). Relative younger age was associated with higher levels of ADHD symptoms in the 1993 Pelotas Cohort (p = .003), 2004 Pelotas Cohort (p = .046), and HRC study (p = .010). CONCLUSION Children and adolescents who are relatively younger compared with their classmates have a higher risk of receiving an ADHD diagnosis. Clinicians should consider the developmental level of young children when evaluating ADHD symptoms.
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Affiliation(s)
- Arthur Caye
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Sandra Petresco
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Rodrigo A Bressan
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Ary Gadelha
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Arthur Gus Manfro
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Alícia Matijasevich
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil; Faculty of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
| | | | - Euripides C Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | | | - Pedro M Pan
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Giovanni A Salum
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Christian Kieling
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luis Augusto Rohde
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil.
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Mahajnah M, Sharkia R, Shorbaji N, Zelnik N. The Clinical Characteristics of ADHD Diagnosed in Adolescents in Comparison With Younger Children. J Atten Disord 2020; 24:1125-1131. [PMID: 28367712 DOI: 10.1177/1087054717696768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: The aim of this study is to identify the clinical characteristics in adolescents newly diagnosed with ADHD. Method: Data of patients aged 7 to 17 years diagnosed with ADHD were collected and analyzed. The patients were divided into adolescents aged 13 to 17 years (Group I) and children aged 7 to 12 years (Group II): 592 males and 231 females. Group I consists of 450 participants, and Group II consists of 373 participants. Results: Adolescents were predominantly inattentive (63.8%); most of Group II patients had combined or hyperactive ADHD (70.8%). Learning disorders were more common in adolescents (51.2% vs. 39.7%) and treated mainly with long-acting methylphenidate (MPH), and Group II patients were treated mainly with short- and medium-acting MPH. Newly diagnosed adolescents were less likely to exhibit behavioral comorbidities. Headache and insomnia were reported more in adolescents, and stimulant rebound effect was more in younger children. Conclusion: Although the biological nature of ADHD is similar in both age groups, the primary symptomatology and associated comorbidities are prone to age-dependent changes.
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Affiliation(s)
- Muhammad Mahajnah
- Hillel Yaffe Medical Center, Hadera, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Rajech Sharkia
- The Triangle Regional Research and Development Center, Kfar Qara, Israel.,Beit Berl Academic College, Israel
| | - Nadeem Shorbaji
- Hillel Yaffe Medical Center, Hadera, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Nathanel Zelnik
- Hillel Yaffe Medical Center, Hadera, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel.,Haifa District and Carmel Medical Center, Israel
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