THESES
ATTENTION DEFICIT HYPERACTIVITY DISORDER: PREVALENCE AND CONTRIBUTION ON PSYCHO-SOCIAL FACTORS (ABSTRACT)* * Transtorno de déficit de atenção/hiperatividade: prevalência e contribuição dos fatores psicossociais (Resumo). Dissertação de Mestrado, Universidade Federal Fluminense (Área: Pediatria). Orientador: Jairo Werner Júnior. . DISSERTATION. NITEROI, 2001.
MARCIO MOACYR DE VASCONCELOS** * Transtorno de déficit de atenção/hiperatividade: prevalência e contribuição dos fatores psicossociais (Resumo). Dissertação de Mestrado, Universidade Federal Fluminense (Área: Pediatria). Orientador: Jairo Werner Júnior.
OBJECTIVE - To define prevalence of attention deficit/hyperactivity disorder (ADHD) in a population of school-age children, and to explore the contribution of psychosocial risk factors to its occurrence.
METHOD - The study population was composed of all pupils who attended the first five grades at a public state elementary school, which received children from nearby slums. During the research first stage, school teachers and parents filled a standardized questionnaire of 18 ADHD symptoms. In the second stage, children who screened positive and their parents were invited for a medical visit at school. After signature of an informed consent, the following procedures were done: symptoms questionnaire, psychosocial questionnaire and medical assessment. ADHD diagnosis was subdivided into three types: predominantly hyperactive, predominantly inattentive, and mixed type. Some pupils whose screening was negative were paired with diagnosed children. Statistical methods included univariate analysis and multiple logistic regression analysis in order to assess statistical significance of 20 major psychosocial variables in association with ADHD. A case-control paired study was done (31 pairs), then an analysis of the whole sample was undertook, taking in account three subgroups of pupils - affected children, indeterminate children, and controls.
RESULTS - Among 403 pupils recruited in the first stage, 108 screened positive. Of these, 101 were assessed, as well as 31 control children (n = 132). There were 88 boys and 44 girls. Mean age was 9.3 years (standard deviation 1.99). ADHD diagnosis was defined for 69 pupils (prevalence of 17.1%). The one psychosocial factor which displayed most consistent statistical significance was "past marital discord"; other psychosocial factors found to be significant in univariate analysis were "parental separation", "maternal depression", "alcohol use by mother", and "crowded living conditions". Multivariate analysis found the following significant psychosocial factors: "past marital discord", "maternal depression", and "alcohol use by mother". This study also found a high frequency of death by murder of close relatives, and this variable was statistically significant in some analyses.
CONCLUSIONS - ADHD prevalence was 17.1%. The most significant psychosocial factor was "past marital discord". Evidence was found that exposure to community violence could have an additional impact in children previously predisposed to ADHD and precipitate it.
KEY WORDS: attention deficit disorder, hyperactivity, child, etiology, psycho-social factors, prevalence.
**Address: Rua das Laranjeiras 391 / 208, 22240-002 Rio de Janeiro RJ, Brasil. E-mail: mmvascon@centroin.com.br
Publication Dates
-
Publication in this collection
19 July 2002 -
Date of issue
June 2002