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Attallah O. ADHD-AID: Aiding Tool for Detecting Children's Attention Deficit Hyperactivity Disorder via EEG-Based Multi-Resolution Analysis and Feature Selection. Biomimetics (Basel) 2024; 9:188. [PMID: 38534873 DOI: 10.3390/biomimetics9030188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
The severe effects of attention deficit hyperactivity disorder (ADHD) among adolescents can be prevented by timely identification and prompt therapeutic intervention. Traditional diagnostic techniques are complicated and time-consuming because they are subjective-based assessments. Machine learning (ML) techniques can automate this process and prevent the limitations of manual evaluation. However, most of the ML-based models extract few features from a single domain. Furthermore, most ML-based studies have not examined the most effective electrode placement on the skull, which affects the identification process, while others have not employed feature selection approaches to reduce the feature space dimension and consequently the complexity of the training models. This study presents an ML-based tool for automatically identifying ADHD entitled "ADHD-AID". The present study uses several multi-resolution analysis techniques including variational mode decomposition, discrete wavelet transform, and empirical wavelet decomposition. ADHD-AID extracts thirty features from the time and time-frequency domains to identify ADHD, including nonlinear features, band-power features, entropy-based features, and statistical features. The present study also looks at the best EEG electrode placement for detecting ADHD. Additionally, it looks into the location combinations that have the most significant impact on identification accuracy. Additionally, it uses a variety of feature selection methods to choose those features that have the greatest influence on the diagnosis of ADHD, reducing the classification's complexity and training time. The results show that ADHD-AID has provided scores for accuracy, sensitivity, specificity, F1-score, and Mathew correlation coefficients of 0.991, 0.989, 0.992, 0.989, and 0.982, respectively, in identifying ADHD with 10-fold cross-validation. Also, the area under the curve has reached 0.9958. ADHD-AID's results are significantly higher than those of all earlier studies for the detection of ADHD in adolescents. These notable and trustworthy findings support the use of such an automated tool as a means of assistance for doctors in the prompt identification of ADHD in youngsters.
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Affiliation(s)
- Omneya Attallah
- Department of Electronics and Communications Engineering, College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport, Alexandria 21937, Egypt
- Wearables, Biosensing and Biosignal Processing Laboratory, Arab Academy for Science, Technology and Maritime Transport, Alexandria 21937, Egypt
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Mitiku KW, Tegegne E, Amsalu M, Habtegiorgis SD, Melaku B. Mental illness in children and its determinants in Ethiopia: A systematic review and meta-analysis, 2023. Clin Child Psychol Psychiatry 2024; 29:168-186. [PMID: 37864448 DOI: 10.1177/13591045231209078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
INTRODUCTION Young people are at risk of developing mental health disorders. Depression, anxiety, and behavioral problems are among the primary causes of illness and impairment among teenagers. Suicide is the fourth highest cause of mortality in those aged 15 to 29. This study aimed to assess the determinants of mental health among children in Ethiopia. METHODS Online databases were searched from inception until March 2023. Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 was used in this review. Subgroup analysis, I2 test, funnel plot, and Egger's test were performed. Pooled odds ratios (OR) were calculated. RESULT Fourteen studies were included in the meta-analysis. The pooled prevalence of mental illnesses among Ethiopian children was 24.68% (95% CI: 19.99%-32.38%). Having previous child abuse history (OR: 5.65; 95% CI: 4.32-7.39), poor socio-economic status (OR: 1.94; 95% CI: 1.24-3.04), urban residence (OR: 1.93; 95% CI:1.39-2.67), and being male (OR: 1.65; 95% CI: 1.15-2.38) were determinants of childhood mental illness in Ethiopia. CONCLUSION and Recommendations: Mental disorders are highly prevalent in children with a history of child abuse, and a strong legislative body must be established to prosecute child abusers. Interventions that focus on gender equality in education and the creation of a safe environment for poor urban children are suggested.
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Affiliation(s)
- Kalkidan Worku Mitiku
- Department of Public Health, College of health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Eniyew Tegegne
- Department of Environmental health, College of health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Menichil Amsalu
- Department of Public Health, College of health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Samuel Derbie Habtegiorgis
- Department of Public Health, College of health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Birhanu Melaku
- School of Medicine and Health Science, Department of Public Health, GAMBY Medical and Business College, Bahirdar, Ethiopia
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Tahir H, Munir N, Iqbal SS, Bacha U, Amir S, Umar H, Riaz M, Tahir IM, Ali Shah SM, Shafiq A, Akram M. Maternal vitamin D status and attention deficit hyperactivity disorder (ADHD), an under diagnosed risk factor; A review. EUR J INFLAMM 2023. [DOI: 10.1177/1721727x231161013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Vitamin D is important to mediate several brain processes such as proliferation, apoptosis, and neurotransmission in early stages of life. Vitamin D deficiency during critical periods of development can lead to persistent brain alterations. Vitamin D homeostasis during pregnancy is affected by two factors which includes an increase in mother’s calcitriol levels and an increase in mother’s Vitamin D Binding protein concentrations. Attention deficient hyperactivity disorder (ADHD) is an outcome of a complicated interaction between genetic, environmental, and developmental traits, and genetic factors cover about 80% of the cases. The efficiency of the immune system can be altered by a deficiency of Vitamin D in maternal body and maternal stress during gestation such as perinatal depression. Studies have proved that during gestation if there is a deficiency of vitamin D in maternal body, it can influence the brain development of the fetus and can also alter the synthesis of the brain-derived neurotropic factor. The current manuscript has been compiled to elaborate different factors which are associated with ADHD particularly focusing on the relationship of vitamin D deficiency in mothers. References material was selected from NCBI (PUBMED), Science direct, Google scholar, Publons etc. Using the terms ADHD, Vitamin D and Maternal nutritional status. Although, controversial relationship was found between the deficiency of Vitamin D level in pregnant women and development of ADHD in children but more controlled trials are required for future direction as well as to rule out other associated causes.
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Affiliation(s)
- Hafsa Tahir
- Department of Nutrition Sciences, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Naveed Munir
- Department of Biomedical Lab Sciences, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Syeda Saira Iqbal
- Knowledge Research and Support Services, University of Management and Technology, Lahore, Pakistan
| | - Umar Bacha
- Department of Nutrition Sciences, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Saira Amir
- Department of Nutrition Sciences, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Hassaan Umar
- School of Pharmaceutical Sciences, Universiti Sains, Malaysia
| | - Muhammad Riaz
- Department of Allied Health Sciences, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan
| | - Imtiaz Mahmood Tahir
- College of Allied Health Professional, Directorate of Medical Sciences, Government College University‐Faisalabad, Faisalabad, Pakistan
| | - Syed Muhammad Ali Shah
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | - Almina Shafiq
- Department of Biomedical Lab Sciences, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
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Olatunji G, Faturoti O, Jaiyeoba B, Toluwabori AV, Adefusi T, Olaniyi P, Aderinto N, Abdulbasit MO. Navigating unique challenges and advancing equitable care for children with ADHD in Africa: a review. Ann Med Surg (Lond) 2023; 85:4939-4946. [PMID: 37811061 PMCID: PMC10553014 DOI: 10.1097/ms9.0000000000001179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/06/2023] [Indexed: 10/10/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that presents distinct challenges for African children due to a complex interplay of social, economic and cultural factors. This review examines the various obstacles faced by children with ADHD in Africa, focusing on the lack of awareness and stigma surrounding the disorder, limited access to mental health services, educational system constraints, economic limitations and cultural beliefs and practices. The review underscores the significance of public awareness campaigns and educational initiatives to dispel myths and misconceptions surrounding ADHD. These efforts should target the general public, educators, healthcare professionals, religious leaders and traditional healers. Crucial to addressing this issue is strengthening mental health services, especially in rural and underserved areas, through increased funding and the availability of trained mental health professionals specialised in ADHD diagnosis and treatment. Integrating mental health services into primary healthcare systems is proposed to enhance accessibility for children with ADHD. By training primary care providers to recognise ADHD symptoms and provide initial support and referrals, early identification and intervention can be facilitated. Addressing the affordability and accessibility of ADHD treatment is a priority, with policy recommendations including subsidising medications and therapies and providing financial assistance to families in need. A call for collaborative efforts between governments, nongovernmental organisations and pharmaceutical companies is advocated to ensure that ADHD treatment is affordable and widely available.
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Affiliation(s)
| | - Olamide Faturoti
- Department of Medicine and Surgery, University of Ilorin, Ilorin
| | | | | | | | - Peter Olaniyi
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Nicholas Aderinto
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Muili O. Abdulbasit
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
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Younis EA, Shalaby SES, Abdo SAEF. Screening of attention deficit hyperactivity disorder among preschool children Gharbia Governorate, Egypt. BMC Psychiatry 2023; 23:285. [PMID: 37098572 PMCID: PMC10126573 DOI: 10.1186/s12888-023-04785-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/13/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Children who experience mental health issues, such as attention deficit hyperactivity disorder (ADHD), experience significant distress and impairment at home, at school, and in the community. Without adequate care or prevention, this frequently results in adulthood-long distress and impairment at large societal costs. Determining the prevalence of ADHD cases among preschoolers as well as some associated maternal and child risk factors was the aim of this study. METHODS An analytical cross-sectional study including 1048 preschool children aged 3-6 years was carried out in Tanta City, Gharbia Governorate. From March to April 2022, a proportionate stratified cluster random sample of them was picked. Data were gathered using a predesigned instrument that included sociodemographic information, family history, maternal and child risk factors, and the Arabic version of the ADHD Rating Scale IV questionnaire. RESULTS The prevalence of ADHD among preschoolers was 10.5%. The inattention type was the most common (5.3%), followed by the hyperactivity type (3.4%). There were statistically significant associations regarding positive family history of psychological and neurological symptoms (17.9% positive vs. 9.7% negative), family history of ADHD symptoms (24.5% positive vs. 9.4% negative), active smoking by the mother (21.1% positive vs. 5.3% negative), cesarean section delivery (66.4% positive vs. 53.9% negative), elevated blood pressure during pregnancy (19.1% positive vs. 12.4% negative), and history of taking drugs during pregnancy (43.6% positive vs. 31.7% negative). Significant child risk factors were: exposure to any source containing lead that causes slow poisoning (25.5% positive vs. 12.3% negative), children with cardiac health problems (38.2% positive vs. 16.6% negative), and hours spent by a child in front of the TV or mobile phone (any screens) per day (60.0% of those with positive screening spent more than 2 h/day vs. 45.7% negative). CONCLUSION In the Gharbia governorate, 10.5% of preschoolers suffer from ADHD. Significant maternal risk factors for ADHD included a positive family history of psychiatric and neurological symptoms, a family history of ADHD symptoms, active maternal smoking, caesarean section delivery, increased blood pressure during pregnancy, and a history of drug use during pregnancy. Youngsters who had cardiac health issues and who spent more time each day watching TV or using a mobile device (screen use) were at substantial risk.
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Affiliation(s)
- Eman Ali Younis
- Department of Public Health & Community Medicine, Faculty of Medicine, Tanta University, Tanta, 31257, Egypt.
| | - Safynaz El Saied Shalaby
- Department of Public Health & Community Medicine, Faculty of Medicine, Tanta University, Tanta, 31257, Egypt
| | - Sanaa Abd El-Fatah Abdo
- Department of Public Health & Community Medicine, Faculty of Medicine, Tanta University, Tanta, 31257, Egypt
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Aliye K, Tesfaye E, Soboka M. High rate of attention deficit hyperactivity disorder among children 6 to 17 years old in Southwest Ethiopia findings from a community-based study. BMC Psychiatry 2023; 23:144. [PMID: 36890504 PMCID: PMC9993367 DOI: 10.1186/s12888-023-04636-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/27/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder is among the common neuropsychiatric disorders affecting children and adolescents. The disorder affects the life of children, their parents, and the community when left untreated. Although evidence indicated a high prevalence of attention-deficit/hyperactivity disorder in the developed world, there is limited evidence in developing countries, particularly, Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of attention deficit hyperactivity disorder among Ethiopian children aged 6 to 17 years. METHODS A community-based cross-sectional study was conducted from August to September 2021 among children aged 6 to 17 years in Jimma town. A multistage sampling technique was applied to select 520 study participants. Data were collected by using the Vanderbilt Attention Deficit Hyperactivity Disorder- Parent Rating scale as a modified, semi-structured, and face-to-face interview. The association between independent variables and the outcome variable was investigated using bi-variable and multivariable logistic regression. The final model level of significance was set at a p-value of < 0.05. RESULT A total of 504 participants were involved in the study with a response rate of 96.9%. The overall prevalence of attention deficit hyperactivity disorder in this study was (9.9%, n = 50). Maternal complication during pregnancy (Adjusted odds ratio (AOR) = 3.56, 95% CI = 1.44-8.79, mothers illiteracy (AOR = 3.10, 95% CI = 1.24-7.79), attending primary school (AOR = 2.97, 95% CI = 1.32-6.73), history of head trauma (AOR = 3.20, 95% CI = 1.25-8.16), maternal alcohol use during pregnancy (AOR = 3.54, 95% CI = 1.26-10), bottle feeding during first six months (AOR = 2.87, 95% CI = 1.20-6.93) and child's age 6-11 years (AOR = 3.86, 95% CI = 1.77-8.43) were significantly associated with attention deficit hyperactivity disorder. CONCLUSION In this study, one in ten children and adolescents in Jimma town had attention deficit hyperactivity disorder. Therefore, the prevalence of attention deficit hyperactivity disorder was high. For this reason, there is a need to pay increased attention to control associated factors of attention deficit hyperactivity disorder and reduce its prevalence.
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Affiliation(s)
- Kemal Aliye
- College of Health and Medical Sciences, Department of psychiatry, Haramaya University, Haramaya, Ethiopia.
| | - Elias Tesfaye
- Institute of health, Facult of medicine, Department of psychiatry, Jimma University, Jimma, Ethiopia
| | - Matiwos Soboka
- Institute of health, Facult of medicine, Department of psychiatry, Jimma University, Jimma, Ethiopia
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Khare SK, Acharya UR. An explainable and interpretable model for attention deficit hyperactivity disorder in children using EEG signals. Comput Biol Med 2023; 155:106676. [PMID: 36827785 DOI: 10.1016/j.compbiomed.2023.106676] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/09/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects a person's sleep, mood, anxiety, and learning. Early diagnosis and timely medication can help individuals with ADHD perform daily tasks without difficulty. Electroencephalogram (EEG) signals can help neurologists to detect ADHD by examining the changes occurring in it. The EEG signals are complex, non-linear, and non-stationary. It is difficult to find the subtle differences between ADHD and healthy control EEG signals visually. Also, making decisions from existing machine learning (ML) models do not guarantee similar performance (unreliable). METHOD The paper explores a combination of variational mode decomposition (VMD), and Hilbert transform (HT) called VMD-HT to extract hidden information from EEG signals. Forty-one statistical parameters extracted from the absolute value of analytical mode functions (AMF) have been classified using the explainable boosted machine (EBM) model. The interpretability of the model is tested using statistical analysis and performance measurement. The importance of the features, channels and brain regions has been identified using the glass-box and black-box approach. The model's local and global explainability has been visualized using Local Interpretable Model-agnostic Explanations (LIME), SHapley Additive exPlanations (SHAP), Partial Dependence Plot (PDP), and Morris sensitivity. To the best of our knowledge, this is the first work that explores the explainability of the model prediction in ADHD detection, particularly for children. RESULTS Our results show that the explainable model has provided an accuracy of 99.81%, a sensitivity of 99.78%, 99.84% specificity, an F-1 measure of 99.83%, the precision of 99.87%, a false detection rate of 0.13%, and Mathew's correlation coefficient, negative predicted value, and critical success index of 99.61%, 99.73%, and 99.66%, respectively in detecting the ADHD automatically with ten-fold cross-validation. The model has provided an area under the curve of 100% while the detection rate of 99.87% and 99.73% has been obtained for ADHD and HC, respectively. CONCLUSIONS The model show that the interpretability and explainability of frontal region is highest compared to pre-frontal, central, parietal, occipital, and temporal regions. Our findings has provided important insight into the developed model which is highly reliable, robust, interpretable, and explainable for the clinicians to detect ADHD in children. Early and rapid ADHD diagnosis using robust explainable technologies may reduce the cost of treatment and lessen the number of patients undergoing lengthy diagnosis procedures.
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Affiliation(s)
- Smith K Khare
- Electrical and Computer Engineering Department, Aarhus University, 8200, Aarhus, Denmark.
| | - U Rajendra Acharya
- School of Mathematics, Physics, and Computing, University of Southern Queensland, Springfield, Australia; Department of Biomedical Engineering, School of Science and Technology, Singapore University of Social Sciences, Singapore; Department of Biomedical Informatics and Medical Engineering, Asia University, Taiwan; Kumamoto University, Japan; University of Malaya, Malaysia
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Mulu GB, Mohammed AY, Kebede WM, Atinafu BT, Tarekegn FN, Teshome HN, Tadese M, Wubetu AD. Prevalence and Associated Factors of Attention-Deficit Hyperactivity Disorder among Children Aged 6-17 Years in North Eastern Ethiopia. Ethiop J Health Sci 2022; 32:321-330. [PMID: 35693560 PMCID: PMC9175227 DOI: 10.4314/ejhs.v32i2.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022] Open
Abstract
Background Attention-deficit hyperactivity disorder is one of the public neurodevelopmental disorders characterized by impulsivity and restlessness or hyperactivity. This study aimed to assess the prevalence of Attention-deficit hyperactivity disorder and its associated factors among children aged 6 to 17 years in Shewa Robit town, Northeastern Ethiopia, 2020. Methods A community-based cross-sectional study was conducted among 365 children aged 6-17 years from Feb 1-March 30, 2020, at Shewa Robit town. Systematic random sampling was employed to select study participants. Data were collected by interview using structured and pretested questionnaires. Finally, data was entered using Epi-data 4.2 and analyzed using SPSS version 25. Bivariable and multivariable binary logistic regression analysis was conducted to identify associated factors of attention deficit hyperactivity disorder. Odds ratios with 95% CI were calculated, and variables having a p-value < 0.05 were considered statistically significant. Result The prevalence of ADHD among children aged 6 to 17 years was 13%. Financial crises [AOR 4.76(95% CI 1.51-15.05)], children a previous history of the mental problem [AOR 8.45(95% CI 1.24-57.43)], C/S delivery [AOR 6.38(95% CI 1.26-32.26)] and substance use in life [AOR 2.43(95% CI 1.09-5.43)] were significantly associated with attention deficit hyperactivity disorder. Conclusion The prevalence of ADHD in children 6 to 17 years old was high (13%). Financial crises, children's history of mental disorders, C/S delivery, and lifetime substance use were significantly associated with attention deficit hyperactivity disorder. Therefore, particular attention should be given to mothers and children with significant factors.
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Affiliation(s)
- Getaneh Baye Mulu
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Ahmed Yimam Mohammed
- The National Tobacco Enterprise (Ethiopia) Share Company (NTE), Northeastern, Ethiopia
| | - Worku Misganaw Kebede
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Bantalem Tilaye Atinafu
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Fetene Nigussie Tarekegn
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Hana Nigussie Teshome
- Department of Anatomy, College of Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Mesfin Tadese
- Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abate Dargie Wubetu
- Department of Psychiatry, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
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Pang X, Wang H, Dill SE, Boswell M, Pang X, Singh M, Rozelle S. Attention Deficit Hyperactivity Disorder (ADHD) among elementary students in rural China: Prevalence, correlates, and consequences. J Affect Disord 2021; 293:484-491. [PMID: 34280772 DOI: 10.1016/j.jad.2021.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 05/13/2021] [Accepted: 06/13/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a widely recognized mental health problem in developed countries but remains under-investigated in developing settings. This study examines the prevalence, correlates, and consequences of ADHD symptoms among elementary school students in rural China. METHODS Cross-sectional data were collected from 6,719 students across 120 rural primary schools in China on ADHD symptoms, demographic characteristics, and academic performance in reading and math. ADHD symptoms were evaluated using the caregiver-reported ADHD Rating Scale-IV. RESULTS The prevalence of ADHD symptoms was 7.5% in our sample. Male students, students in lower grade levels, and students with lower cognitive ability showed a significantly higher prevalence of ADHD symptoms (ORs = 2.56, 2.06, and 1.84, respectively; p<0.05). Left-behind children showed a significantly lower prevalence of ADHD symptoms than did children who were living with their parents (OR = 0.74, p < 0.05). Adjusted regressions show that students with ADHD symptoms scored 0.12 standardized deviations lower in reading (p < 0.05) and 0.19 standardized deviations lower in math (p < 0.01). LIMITATIONS The ADHD Rating Scale-IV is a screening scale rather than a diagnostic test. Caregiver self-report measures also may underestimate ADHD symptoms for our sample. CONCLUSIONS ADHD is a common disorder among rural students in China and appears to be contributing to poor academic outcomes. The higher prevalence of ADHD among students with low cognitive ability also suggests that many rural children in China face multifactorial learning challenges. Taken together, the findings indicate a need for educators and policymakers in rural China to develop programs to reduce risk and support students with ADHD symptoms.
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Affiliation(s)
- Xiaodong Pang
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Huan Wang
- Stanford Center on Chinas Economy and Institutions, Freeman Spogli Institute dor International Studies, Stanford University, Stanford, California, United States.
| | - Sarah-Eve Dill
- Stanford Center on Chinas Economy and Institutions, Freeman Spogli Institute dor International Studies, Stanford University, Stanford, California, United States
| | - Matthew Boswell
- Stanford Center on Chinas Economy and Institutions, Freeman Spogli Institute dor International Studies, Stanford University, Stanford, California, United States
| | - Xiaopeng Pang
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Manpreet Singh
- School of Medicine, Stanford University, Stanford, California, United States; Stanford Pediatric Mood Disorders Program, Stanford University, Stanford, California, United States
| | - Scott Rozelle
- Stanford Center on Chinas Economy and Institutions, Freeman Spogli Institute dor International Studies, Stanford University, Stanford, California, United States
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Benti M, Bayeta AB, Abu H. Attention Deficit/Hyperactivity Disorder and Associated Factors Among Children Attending Pediatric Outpatient Departments of West Shewa Zone Public Hospitals, Central Ethiopia. Psychol Res Behav Manag 2021; 14:1077-1090. [PMID: 34321936 PMCID: PMC8311170 DOI: 10.2147/prbm.s285065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background Attention deficit/hyperactivity disorder is a common childhood-onset neurodevelopmental disorder that affects the child’s psychosocial, educational, neuropsychological functioning self-esteem and quality of life from childhood to adulthood. It is estimated to affect about 5% of children and a third leading cause of disabilities. Objective To assess the prevalence of attention deficit/hyperactivity disorder and its associated factors among children attending pediatric OPD in hospitals found in West Shoa zone, Central Ethiopia, 2020. Methods Institution-based cross-sectional study was conducted from January 2020 to February 2020 among 422 children attending pediatric OPD in selected hospitals in West Shewa Zone and disruptive behavioral rating scale was used to collect data. OPD (out patient department) is section of hospital where patients who receive treatment without staying overnight are seen. Data were entered into Epi info version 7.1.2 and exported to SPSS version 21 for analysis. Descriptive statistics were done. Bivariate logistic regression was done to examine the relationship between different independent variables with attention deficit/hyperactivity disorder. Variable with p-value <0.05 was taken as statistically significant. Results The prevalence rate of attention deficit/hyperactivity disorder (ADHD) among children attending pediatric OPD was 8.4%, 95% CI (5.9, 11.1). Being male (AOR= 3.35, 95% CI (1.52, 7.38), age 6–11 (AOR=3.38 CI (1.22, 9.39)), having a family size greater than five (AOR=3.95, CI (1.44, 10.11)), low family income (AOR=3.47, 95% CI (1.25, 10.10), presence of one or more psychosocial stressors (AOR=4.50, 95% CI (1.77, 9.42)), family history of mental illness (AOR= 3.6, 95% CI (1.78, 8.21)) and mothers having complication during pregnancy (AOR= 3.05, CI (1.10, 8.48)) were factors found to be associated with ADHD. Conclusion Prevalence of attention deficit/hyperactivity disorder in this study is higher than global prevalence. This study has shown us ADHD is a public health issue that requires great emphasis and it is found to be associated with being male, younger age, large family size, low family income, psychosocial stressors, family history of mental illness and complication of pregnancy are factors associated with ADHD.
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Affiliation(s)
- Misael Benti
- Department of psychiatry Nursing, College of Medicine and Health Sciences Ambo University, Ambo, Ethiopia
| | - Adamu Birhanu Bayeta
- Department of psychiatry Nursing, College of Medicine and Health Sciences Ambo University, Ambo, Ethiopia
| | - Haji Abu
- Department of psychiatry Nursing, College of Medicine and Health Sciences Ambo University, Ambo, Ethiopia
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Bhandari R, Kaur J, Kaur S, Kuhad A. The Nrf2 pathway in psychiatric disorders: pathophysiological role and potential targeting. Expert Opin Ther Targets 2021; 25:115-139. [PMID: 33557652 DOI: 10.1080/14728222.2021.1887141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Introduction: All psychiatric disorders exhibit excitotoxicity, mitochondrial dysfunction, inflammation, oxidative stress, and neural damage as their common characteristic. The endogenous nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway is implicated in the defense mechanism against oxidative stress and has a significant role in psychiatric disorders.Areas covered: We explore the role of Nrf2 pathway and its modulators in psychiatric disorders. The literature was searched utilizing various databases such as Embase, Medline, Web of Science, Pub-Med, and Google Scholar from 2010 to 2020. The search included research articles, clinical reports, systematic reviews, and meta-analyses.Expert opinion: Environmental factors and genetic predisposition can be a trigger for the development of psychiatric disorders. Nrf2 downregulates certain inflammatory pathways and upregulates various antioxidant enzymes to maintain a balance. However, its intricate balance with NF-Kβ (Nuclear factor kappa light chain enhancer of activated B cells) and its crosstalk with the transcription factor Nrf2 is critical in severe oxidative stress. Several Nrf2 modulators are now in clinical trials and can help reduce oxidative stress and neuroinflammation. There are immense potential opportunities for these modulators to become a novel therapeutic option.
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Affiliation(s)
- Ranjana Bhandari
- Pharmacology Research Laboratory, University Institute of Pharmaceutical Sciences, UGC-Centre of Advanced Study, Panjab University, Chandigarh, India
| | - Japneet Kaur
- Pharmacology Research Laboratory, University Institute of Pharmaceutical Sciences, UGC-Centre of Advanced Study, Panjab University, Chandigarh, India
| | - Simerpreet Kaur
- Pharmacology Research Laboratory, University Institute of Pharmaceutical Sciences, UGC-Centre of Advanced Study, Panjab University, Chandigarh, India
| | - Anurag Kuhad
- Pharmacology Research Laboratory, University Institute of Pharmaceutical Sciences, UGC-Centre of Advanced Study, Panjab University, Chandigarh, India
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12
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Yeom CW, Oh GH, Jung S, Moon JY, Son KL, Kim WH, Jung D, Baik M, Shim EJ, Moon H, Hahm BJ. Prevalence and comorbidities of adult adhd in male military conscripts in korea: Results of an epidemiological survey of mental health in korean military service. Psychiatry Res 2020; 293:113401. [PMID: 32861097 DOI: 10.1016/j.psychres.2020.113401] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 01/30/2023]
Abstract
We assessed the prevalence/comorbidities of attention deficit hyperactivity disorder (ADHD) in Korean servicemen using the Epidemiological Survey of Mental Health in Military Service in Korea. A total of 3,441 participants were assessed for adult ADHD, depression, social anxiety, generalized anxiety, somatization, insomnia, suicidality, cigarette dependence, and alcohol dependence using a self-report scale. Participants were also asked to rank their perception of their career prospects, health status, and quality of life on a Likert scale. Participants were classified as ADHD according to the WHO A-ADHD self-report scale. Firth multiple logistic regression and Cochran-Armitage trend tests were used to identify the risks of comorbidities and trends of self-perception between the two groups. ADHD (prevalence: 2.8%) was significantly associated with social anxiety (OR, 40.52; 95% CI 25.14-65.74), generalized anxiety (OR, 28.21; 95% CI 17.37-45.69), depression (OR, 16.36; 95% CI 10.50-25.52), somatization (OR, 14.47; 95% CI 9.21-22.76), suicidality (OR, 11.03; 95% CI 6.67-17.86), and insomnia (OR, 5.92; 95% CI 3.68-9.35). Servicemen with ADHD had negative perceptions (p <0.001) of their career prospects, health status, and quality of life compared to servicemen without ADHD. It is essential to revise the enlistment criteria for individuals with ADHD or to develop management programs for servicemen with ADHD.
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Affiliation(s)
- Chan-Woo Yeom
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Gyu Han Oh
- Public Health Medical Service, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sanghyup Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Yoon Moon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Lak Son
- Department of Neuropsychiatry, Dongguk University Ilsan Hospital, Gyeonggi-do, Republic of Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Dooyoung Jung
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Myungjae Baik
- Department of Mental Health Center, The Armed Forces Capital Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Hoseok Moon
- Department of Defense Science, Korea National Defense University, Chungcheongnam-do, Republic of Korea
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.
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