[Children's and adolescents' perception of their quality of life in cases of attention deficit hyperactivity disorder with and without pharmacological treatment and in controls]. / Percepcion de niños y adolescentes sobre la calidad de vida en casos de trastorno por deficit de atencion/hiperactividad con y sin tratamiento farmacologico y en controles.

INTRODUCTION: Health-related quality of life perceived by children and teenagers is important to assess the effects of therapeutic intervention. AIM: To analyze quality of life, comparing cases of attention deficit hyperactivity disorder (ADHD) treated with methylphenidate, untreated cases and controls. SUBJECTS AND METHODS: Sampling of 228 participants between 8 and 14 years-old. Consecutive sampling in ADHD according to DSM-IV criteria (ADHD Rating Scales IV) and random sampling of matched controls by sex and age. Evaluation of quality of life using KIDSCREEN-52 (children version). ANOVA with Bonferroni correction was used. RESULTS: There is a moderate significant correlation between greater intensity of ADHD symptoms and worse quality of life, except in the dimension of physical well-being. Cases of untreated ADHD have significantly worse quality of life than controls on psychic well-being, mood, autonomy school environment and social acceptance. Cases of treated ADHD present similar results, except in the school environment and psychological well-being. The cases of ADHD treated only differ significantly from ADHD not treated in having a better school environment. CONCLUSIONS: The cases of ADHD present dimensions of KIDSCREEN-52 with worse quality of life than controls and the cases of ADHD treated with methylphenidate only differ significantly from those not treated in presenting better results in the school environment.

TITLE: Percepcion de niños y adolescentes sobre la calidad de vida en casos de trastorno por deficit de atencion/hiperactividad con y sin tratamiento farmacologico y en controles.Introduccion. La calidad de vida relacionada con la salud percibida por niños y adolescentes es un factor importante para valorar los efectos de una intervencion terapeutica. Objetivo. Analizar la calidad de vida comparando casos con trastorno por deficit de atencion/hiperactividad (TDAH) tratados farmacologicamente con metilfenidato, casos no tratados y controles. Sujetos y metodos. Muestra de 228 participantes de 8-14 años. Muestreo consecutivo de casos de TDAH segun los criterios del Manual diagnostico y estadistico de los trastornos mentales, cuarta edicion, y muestreo aleatorio de controles emparejados por sexo, edad y zona sociodemografica. Evaluacion de la calidad de vida mediante el KIDSCREEN-52 (version niños y adolescentes). Para responder al objetivo se utilizo ANOVA con correccion de Bonferroni. Resultados. Observamos una correlacion significativa moderada entre mayor intensidad de sintomas de TDAH y peor calidad de vida, excepto en el bienestar fisico. Los casos de TDAH no tratados tienen significativamente peor calidad de vida que los controles en bienestar psiquico, autonomia, estado de animo, entorno escolar y aceptacion social. Los casos de TDAH tratados observan similares resultados excepto en el entorno escolar y el bienestar psiquico, que no presentan diferencias significativas con los controles. Los casos de TDAH tratados por comparacion con los de TDAH no tratados solo presentan significativamente mejor calidad de vida en el entorno escolar. Conclusion. Los casos de TDAH presentan dimensiones del KIDSCREEN-52 con peor calidad de vida que los controles y los casos de TDAH tratados con metilfenidato solo se diferencian significativamente de los no tratados porque presentan mejores resultados en el entorno escolar.

Características del asma infantil en Atención Primaria. Mejora del seguimiento / The asthma in children is the second cause of infantile chronic morbidity, consuming great part of the sanitary resources

El asma infantil es la segunda causa de morbilidad crónica infantil consumiendo gran parte de los recursos sanitarios. Material y métodos: estudiamos de forma transversal 1.509 historias de pacientes de 6 a14 años, seguidos en un centro de salud de la meseta castellana (España). Resultados: la edad media de los niños con asma fue 8,9 años con un ligero predominio en varones, la prevalencia acumulada de 11,9% y en los últimos 3 años del 9%. La edad de inicio fue de 3,5 años. Presentaban antecedentes familiares de enfermedad atópica el 39,4% y personales en el 54,7%. Otra patología respiratoria se halló en el 51,4%. El 89,8% de los niños erancontrolados en Atención Primaria, las pruebas de estudio de sensibilización alérgica se realizaron en el 44,1% y la función pulmonar en el 48,8%. Conclusiones: el seguimiento mayoritario de estos pacientes se ha realizado en Atención Primaria y ha permitido una mejora en el control de los pacientes (AU)

The asthma in children is the second cause of infantile chronic morbidity, consuming greatpart of the sanitary resources. Methodology: we made of cross-sectional study of 1,509 histories of patients of 6 to 14 years, followed in Primary Care in the Castilian plateau (Spain). Results: the average age was 8.9 years with a slight predominance of males, accumulated prevalence of 11.9% and in the last 3 years of 9%. The age of onset was 3.5 years. Familiar atopic disease was present in 39.4% and personal antecedents in 54.7%. Another respiratory condition was present in 51.4%. Eighty-nine point eight percent of the children were controlled in primary care. Forty-four point one percent of children had sensitization tests performedand 48.8% had undergone tests of pulmonary function. Conclusions: most of the follow up of these patients takes place in Primary Care and thisfact has allowed an improvement in the control of the patients (AU)

[Attention deficit hyperactivity disorder: intellectual profile and the freedom from distraction factor]. / Trastorno por déficit de atención/hiperactividad: perfil intelectual y factor de independencia a la distracción.

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) usually presents a neuropsychological profile in which the freedom from distraction factor (FDF) is affected to a greater extent than the verbal comprehension factor (VCF) and the perceptual organisation factor (POF). AIM: To determine the intellectual profile of clinical cases with ADHD through a specific analysis of the FDF, in which we evaluated the differences compared with the VCF and the POF, between types of ADHD and with WISC-R criteria, as well as the variables that affect the probability of FDF < VCF and POF. PATIENTS AND METHODS: Our study involved a clinical sample of 167 cases of ADHD between 6 and 16 years of age. The cases were defined according to DSM-IV criteria and the evaluation was performed using WISC-R, the Child Symptom Inventory and the social and occupational activity assessment scale. Both descriptive and exploratory statistics were used. Means were compared using ANOVA and/or t tests. Alpha was accepted if it was equal to or below 0.05 and a logistic regression method was used (alpha model parameters below or equal to 0.05). In each factor a 95% confidence interval and odds ratio were determined. RESULTS: The criterion FDF < VCF and FOP accounted for 71.3% of the cases with ADHD and FDF < (VCF + POF) / 2 represented 81.4% (sensitivity: 81.4%). The FDF is significantly lower than both the mean that corresponds to factorial criteria derived from the WISC-R and the VCF and POF in the cases that were analysed. The mean FDF scores were significantly higher in ADHD-H (a type in which hyperactive-impulsivity predominates) than in ADHD-C (combined type) and ADHD-I (inattentive type). Comorbidity, social or school activity and intellectual quotient do not have a significant influence on the probability that FDF < VCF and POF. CONCLUSIONS: The FDF is a neuropsychological dimension that is useful in evaluating ADHD.

Trastorno por déficit de atención/hiperactividad: perfil intelectual y factor de independencia a la distracción / Attention deficit hyperactivity disorder: intellectural profile and the freedom from distraction factor

Introducción. El trastorno por déficit de atención/hiperactividad (TDAH) suele presentar un perfil neuropsicológico, donde el factor de independencia a la distracción (FID) se encuentra mas afectado que el factor de comprensión verbal (FCV) y el factor de organización perceptiva (FOP). Objetivo. Conocimiento del perfil intelectual de casos clínicos con TDAH. Se implementó un análisis específico del FID en el que se valoran las diferencias con FCV y FOP, entre tipos de TDAH y con baremos del WISC-R. Se analizaron las variables que influyen en la probabilidad de FID < FCV y FOP. Pacientes y métodos. Muestra clínica de 167 casos de TDAH, entre 6 y 16 años. Los casos fueron definidos según criterios del DSM-IV y la evaluación incluye las pruebas WISC-R, Child Symptom Inventory y escala de evaluación de actividad social y laboral. Utilizamos estadísticos descriptivos y exploratorios. La comparación entre medias utilizó pruebas t y/o ANOVA. Se aceptó alfa menor o igual a 0,05. Se utilizó un método de regresión logística y en cada factor se determinó odds ratio e intervalo de confianza al 95% (alfa menor o igual a 0,05). Resultados. El criterio FID < FCV y FOP representa el 71,3% de los casos con TDAH y FID < (FCV + FOP) / 2 el 81,4% (sensibilidad: 81,4%). El FID es significativamente más bajo que la media correspondiente a baremos factoriales derivados del WISC-R y que el FCV y FOP de los casos analizados. El FID presenta puntuaciones medias significativamente más altas en TDAH-H (tipo con predominio hiperactivo-impulsivo) que en TDAH-C (tipo combinado) y TDAH-I (tipo inatento). La comorbilidad, la actividad social o escolar y el cociente intelectual no influyen significativamente en la probabilidad FID < FCV y FOP. Conclusión. El FID es una dimensión neuropsicológica útil en la evaluación del TDAH

Introduction. Attention deficit hyperactivity disorder (ADHD) usually presents a neuropsychological profile in which the freedom from distraction factor (FDF) is affected to a greater extent than the verbal comprehension factor (VCF) and the perceptual organisation factor (POF). Aim. To determine the intellectual profile of clinical cases with ADHD through a specific analysis of the FDF, in which we evaluated the differences compared with the VCF and the POF, between types of ADHD and with WISC-R criteria, as well as the variables that affect the probability of FDF < VCF and POF. Patients and methods. Our study involved a clinical sample of 167 cases of ADHD between 6 and 16 years of age. The cases were defined according to DSM-IV criteria and the evaluation was performed using WISC-R, the Child Symptom Inventory and the social and occupational activity assessment scale. Both descriptive and exploratory statistics were used. Means were compared using ANOVA and/or t tests. Alpha was accepted if it was equal to or below 0.05 and a logistic regression method was used (alpha model parameters below or equal to 0.05). In each factor a 95% confidence interval and odds ratio were determined. Results. The criterion FDF < VCF and FOP accounted for 71.3% of the cases with ADHD and FDF < (VCF + POF) / 2 represented 81.4% (sensitivity: 81.4%). The FDF is significantly lower than both the mean that corresponds to factorial criteria derived from the WISC-R and the VCF and POF in the cases that were analysed. The mean FDF scores were significantly higher in ADHD-H (a type in which hyperactive-impulsivity predominates) than in ADHD-C (combined type) and ADHD-I (inattentive type). Comorbidity, social or school activity and intellectual quotient do not have a significant influence on the probability that FDF < VCF and POF. Conclusions. The FDF is a neuropsychological dimension that is useful in evaluating ADHD

El psicólogo clínico y el trastorno por déficit de atención con hiperactividad: vinculación con el pediatra / No disponible

El psicólogo clínico es un profesional sanitario implicado en intervenciones asociadasal trastorno por déficit de atención con hiperactividad (TDAH) en el campo del diagnóstico,evaluación y tratamiento. Su trabajo en el ámbito sanitario público, relacionado con lapediatría de Atención Primaria, se encuentra ubicado en equipos multiprofesionales de saludmental, en colaboración con dispositivos sociales, sanitarios y educativos. Su papel escolaborar en el necesario tratamiento integral e integrado de los casos de TDAH.En su vinculación con la pediatría de Atención Primaria, es un necesario complementoa su intervención en el área de la interconsulta y/o un referente cuando se desee una evaluaciónmás amplia del caso, presente dudas de diagnóstico diferencial psicopatológico,precise la implementación de terapias especializadas o necesite derivar un caso complicadopor comorbilidad y/o falta de respuesta al tratamiento

The clinical psychologist is a sanitary professional implied in interventions associatedto attention deficit hyperactivity disorder (ADHD). He has capacity for the diagnosis, evaluationand treatment of ADHD. His work in the public sanitary environment is related withPrimary Care physicians. The clinical psychologist is located in multi-professional equipmentof mental health, in cooperation with social, sanitarian and educational services.His role is to cooperate in the integral and integrated treatment of ADHD.In his relation with Primary Care Paediatrics, can achieve the following roles: internalconsult, full evaluation of ADHD, psychopathological differential diagnose of ADHD, specializedtherapies, treatment of comorbid psychopathology and cases with lack of therapeuticanswer