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Age-dependent presentation in children with attention 
 
Age-dependent presentation in children with attention
  Gian Paolo Ramelli, Fabio Leoni
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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

 

 
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