Predictors of ADHD persistence in elementary school children who were assessed in earlier grades: A prospective cohort study from Istanbul, Turkey.

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorders among school-age children worldwide. In a more recent follow-up study, Biederman et al. found that 78% of children diagnosed with ADHD between the ages of 6-17 years continued to have a full (35%) or a partial persistence after eleven years. OBJECTIVE: In this study, it was aimed to identify the factors contributing to the persistence of ADHD symptoms in elemantary school children who were prospectively assessed both in their earlier and upper grades. METHODS: The sample was drawn from a previous community-based study where ADHD symptoms in 3696 first/or second graders were examined in regard to their school entry age. Two years after, the families of the children that participated in the initial study were called by phone and invited to a re-evaluation session. Among those who were reached, 154 were consequently eligible and were assessed with Swanson, Nolan and Pelham questionnaire (SNAP-IV), Conners' rating scales (CRS) and the Kiddie schedule for affective disorders and schizophrenia (K-SADS). RESULTS: Of the 154 children, 81 had been evaluated to have "probable ADHD" by the initial interview. Among these 81 children, 50 (61.7%) were indeed diagnosed with ADHD after two years. Initial scores of the teacher reported SNAP-IV inattention subscale predicted the ADHD diagnosis after two years, with an odds ratio of 1.0761 (p = 0.032, Wald: 4.595). CONCLUSIONS: Our results suggest that high inattention symptom scores reported by the teacher in the earlier grades, might predict an ADHD diagnosis in upper grades.

Association Between Age of Beginning Primary School and Attention Deficit Hyperactivity Disorder.

OBJECTIVE: In April 2012, the Turkish national education system was modified, and the compulsory school age of entry (first grade) was redefined as a minimum of 60 months and a maximum of 66 months (replacing the former minimum criterion of 72 months). In this study, we hypothesized that students starting school before 72 months (the previous age standard for the first grade) may experience (1) a greater number of symptoms of attention deficit hyperactivity disorder (ADHD) and (2) lower functioning in social, behavioral, and academic domains. METHOD: We performed a cross-sectional community-based study in the first and second grades of all primary schools (4356 students) located in the Kadiköy county of Istanbul, Turkey. Teachers completed Swanson, Nolan, and Pelham version IV and Conners' Teacher's report forms for symptoms of ADHD, the Perceived Competence Scale for functioning, and a sociodemographic questionnaire. RESULTS: Among first graders, the group that began primary school before the age of 72 months had a higher ADHD prevalence than both of the groups that began primary school between the ages of 72 to 77 months and 78 to 83 months (p < .001 for both groups). ADHD symptoms diminished and academic, social, and behavioral functioning improved with age for the first and second grade students. CONCLUSION: The probability of displaying ADHD symptoms (and caseness) is greater among the "earlier" beginners, whereas the "conventional" classmates exhibited better academic, social, and behavioral functioning.

Oxytocin system social function impacts in children with attention-deficit/hyperactivity disorder.

To investigate relationships between the polymorphisms and social functioning of children with Attention Deficit/Hyperactivity Disorder (ADHD), according to the polymorphism of three oxytocin receptor (OXTR) genes (rs53576, rs13316193, and and rs2268493). A total of 198 children-studying in the same primary and secondary school and matched in terms of age and gender (99 ADHD, 99 control)-were included in this study. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version was administered to establish the clinical diagnosis. The Social Reciprocity Scale (SRS) was applied to evaluate social functioning. The total genomic DNA was isolated from buccal mucosa samples. No significant differences were determined between the ADHD and control groups in terms of rs2268493, rs13316193, and rs53576 genotype distribution (P = 0.078, P = 0.330, and P = 0.149, respectively). However, the control group T allele frequency in the OXTR Single Nucleotide Polymorphism (SNP) rs2268493 was significantly higher than the ADHD group (P = 0.024). Compared to the control group, the ADHD group had a higher score on the SRS scale (SRS total; Z = -21,135, P < 0.001). No significant difference existed in the SRS scale scores between the children with the T/T genotype and the C allele in the ADHD group (SRS total; Z = -0.543, P = 0.587). The allele distribution of the OXTR gene SNP rs2268493 was significantly different in the ADHD group, compared to the control group. This observation is important in understanding the underlying biological infrastructure in ADHD and developing treatment modalities.

Cognitive and psychosocial development in children with familial hypomagnesaemia.

AIM: Familial hypomagnesaemia (FH) is a rare genetic condition. Neuromuscular and cardiovascular manifestations are well described, whereas cognitive and psychosocial development of children with FH is generally overlooked. METHODS: Nine patients with FH were evaluated with psychiatric examination and psychometric tests for cognitive and psychosocial outcome. RESULTS: Nine children (median age 10.1 yrs, range 3-16.3 yrs, 5 boys and 4 girls) with FH participated. Psychiatric symptoms were hyperactivity, irritability, sleep and speech problems and finger sucking. Common psychiatric diagnoses were Attention Deficit Hyperactivity Disorder, borderline intelligence, mild mental retardation and speech disorders. Parent-rated Child Behavior Checklist and Child Health Questionnaire mean scores were between 0.32-0.79, and 0.4-2.12, respectively; indicating the worsened psychosocial well-being besides considerable psychiatric diagnoses. CONCLUSIONS: Cognitive and psychosocial outcome in FH may influence morbidity, quality of life and social performance. Neuropsychiatric evaluation should be a routine part of management of children with FH.