|
Age-dependent presentation in children with
attention deficit hyperactivity disorder
Letter to the Editor
Inattention, hyperactivity and impulsivity characterize attention deficit hyperactivity disorder, the most frequently encountered behavioral abnormality in childhood.[1] The symptoms of the disorder, which is differentiated into a predominantly inattentive, a pre-dominantly hyperactive-impulsive, and a combined subtype, often persist across adolescence into adulthood.[1]
Between 2004 and 2006 we used the criteria provided by The Year 2000 Diagnostic & Statistical Manual for Mental Disorders to make the new diagnosis of attention deficit hyperactivity disorder in 97 Swiss children (89 boys and 8 girls aged between 3 and 14 years) with neurobehavioral abnormalities referred to us.[1,2] We made the diagnosis of pre-dominantly combined subtype in 41 (42%), that of predominantly inattentive subtype in 38 (39%), and that of predominantly hyperactive-impulsive subtype in the remaining 18 (19%) children.[1,2]
Preschool age children (6 years of age or less) mostly presented with symptoms of the predominantly hyperactive-impulsive subtype (50%), primary school age children (7-10 years of age) with symptoms of the combined subtype (45%), and secondary school age children (10 years of age or more) with symptoms of the predominantly inattentive subtype (67%) (Fig.). The difference was statistically significant (P<0.05).
To our knowledge, this is the first report to show an age-dependent presentation in children with attention deficit hyperactivity disorder. The observation likely reflects the quality of life of untreated children. The predominantly hyperactive-impulsive subtype of the disorder generates a major burden for the patient and especially his family earlier in life than the predominantly inattentive subtype. As a consequence, children with the predominantly hyperactive-impulsive subtype disorder are referred to specialist services relatively soon.
Gian Paolo Ramelli, Nadia Zanda, Mario G. Bianchetti
Department of Pediatrics, San Giovanni Hospital,
Bellinzona, Switzerland
Email: gpramelli@bluewin.ch
Fabio Leoni
High School of Pedagogy,
Locarno, Switzerland
References
1 Dreyer BP. The diagnosis and management of attention-deficit/hyperactivity disorder in preschool children: the state of our knowledge and practice. Curr Probl Pediatr Adolesc Health Care 2006;36:6-30.
2 Stein MT, Perrin JM. Diagnosis and treatment of ADHD in school-age children in primary care settings: a synopsis of the AAP Practice Guidelines. American Academy of Pediatrics. Pediatr Rev 2003;24:92-98.
doi:10.1007/s12519-010-0015-4
|
