Factors associated with the control of nuclear symptoms in pediatric patients with Attention Deficit Hyperactivity Disorder in a specialized center in Medellín between 2018 and 2019

Main Article Content

Daniel Alejandro Restrepo Arbeláez
Santiago Sepúlveda López
María Alejandra Parra Cardona
Daniela Sánchez Acosta
Cristóbal Restrepo Conde

Abstract

Objective: Attention Deficit Hyperactivity Disorder (ADHD) has been described as the most common neurodevelopmental disorder in childhood. This condition is associated with significant deterioration in the quality of life, multiple comorbidities and, in the long term, lower academic and work achievements. Despite the fact that it has been shown that patients of Latin descent present a possible underdiagnosis, that in Colombia higher prevalence has been estimated than those described worldwide, and that the effects of the Covid-19 pandemic have been able to exacerbate this problem, the volume of studies with reproducible estimates on the characteristics, treatments received, and symptom control of these patients still needs to be expanded. This study seeks to establish the sociodemographic, clinical and treatment factors associated with the control of the core symptoms of this disorder, which consist of persistent and generalized patterns of inattention, impulsivity and hyperactivity.


Methodology: Descriptive study with analytical intent in a retrospective cohort of pediatric patients with attention deficit hyperactivity disorder followed up for 6 months in a specialized center in Medellín, Colombia, between 2018 and 2019.


Results: An incidence of symptom control of 46.7% was identified, which was significantly associated with adherence to treatment and with a family history of ADHD.


Conclusions: It can be affirmed that, in pediatric patients with ADHD, these factors could increase the probability of achieving control of nuclear symptoms.

Keywords:
attention deficit hyperactivity disorder, neurodevelopmental disorders, population characteristics, treatment adherence, multimodal treatment

Article Details

Author Biographies

Daniel Alejandro Restrepo Arbeláez, Universidad CES

CES University, Medellin, Colombia.

Santiago Sepúlveda López, Comprehensive Neuropediatric Care Center

Comprehensive Neuropediatric Care Center, Medellín, Colombia.

María Alejandra Parra Cardona, Comprehensive Neuropediatric Care Center

Comprehensive Neuropediatric Care Center, Medellín, Colombia.

Daniela Sánchez Acosta, Universidad CES

CES University, Medellin, Colombia.

Cristóbal Restrepo Conde, Pontifical Bolivarian University

Universidad Pontificia Bolivariana, Medellin, Colombia.

References

Swaiman KF, Ashwal S, Ferriero DM, Schor NF, Finkel RS, Gropman AL, et al. Swaiman’s Pediatric Neurology E-Book: Principles and Practice. Elsevier Health Sciences; 2017.

Spetie L, Arnold E, Martin A, Bloch M, Volkmar F. Lewis’s child and adolescent psychiatry: a comprehensive textbook. 2018.

Taylor E, Sonuga-Barke E. Disorders of Attention and Activity. En: Rutter’s Child and Adolescent Psychiatry. John Wiley & Sons, Ltd; 2008 [citado 7 de mayo de 2022]. 519-42.

Hechtman L, Swanson JM, Sibley MH, Stehli A, Owens EB, Mitchell JT, et al. Functional adult outcomes 16 years after childhood diagnosis of attention-deficit/hyperactivity disorder: MTA results. J Am Acad Child Adolesc Psychiatry. 2016;55(11):945-52.

Subcommittee on Attention-Deficit/Hyperactivity Disorder. tdah: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;128(5):1007-22.

Molina BSG, Hinshaw SP, Swanson JM, Arnold LE, Vitiello B, Jensen PS, et al. The MTA at 8 Years: Prospective follow-up of children treated for combined-type ADHD in a multisite study. J Am Acad Child Adolesc Psychiatry. 2009;48(5):484-500.

Molina BS, Hinshaw SP, Eugene L, Swanson JM, Pelham WE, Hechtman L, et al. Adolescent substance use in the multimodal treatment study of attention-deficit/hyperactivity disorder (ADHD) (MTA) as a function of childhood ADHD, random assignment to childhood treatments, and subsequent medication. J Am Acad Child Adolesc Psychiatry. 2013;52(3):250-63.

Dvorsky MR, Langberg JM. A review of factors that promote resilience in youth with ADHD and ADHD symptoms. Clin Child Fam Psychol Rev. 2016;19(4):368-91.

Belcher JR. Attention deficit hyperactivity disorder in offenders and the need for early intervention. Int J Offender Ther Comp Criminol. 2014;58(1):27-40.

Haynes V, López-Romero P, Anand E. Attention-deficit/hyperactivity disorder under treatment outcomes research (AUTOR): a European observational study in pediatric subjects. ADHD Atten Deficit Hyperact Disord. 2015;7(4):295-311.

Catala-López F, Hutton B, Núñez-Beltrán A, Page MJ, Ridao M, Saint-Gerons DM, et al. The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review with network meta-analyses of randomised trials. Plos One. 2017;12(7):e0180355.

Cornejo J, Osío O, Sánchez Y, Carrizosa J, Sánchez G, Grisales H, et al. Prevalencia del trastorno por déficit de atención-hiperactividad en niños y adolescentes colombianos. Rev Neurol. 2005;40(12):716-22.

O’Connor C, McNicholas F. What differentiates children with ADHD symptoms who do and do not receive a formal diagnosis? Results from a prospective longitudinal cohort study. Child Psychiatry Hum Dev. 2019;1-13.

Osooli M, Ohlsson H, Sundquist J, Sundquist K. Attention deficit hyperactivity disorder in firstand second-generation immigrant children and adolescents: A nationwide cohort study in Sweden. J Psychosom Res. 2021;141:110330.

Palacio JD. Algoritmo latinoamericano de tratamiento multimodal del trastorno por déficit de atención e hiperactividad (tdah) a través de la vida. Revista Colombiana de Psiquiatría. 2009;38(1):31.

Zuluaga AMD. Research experience in psychiatric genetics in Colombia: Ongoing studies. Eur Neuropsychopharmacol. 2019;29:S719.

Arcos-Burgos M, Castellanos F, Konecki D, Lopera F, Pineda D, Palacio J, et al. Pedigree disequilibrium test (PDT) replicates association and linkage between DRD4 and ADHD in multigenerational and extended pedigrees from a genetic isolate. Mol Psychiatry. 2004;9(3):252.

Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA. ADHD prevalence estimates across three decades: An updated systematic review and meta-regression analysis. Int J Epidemiol. 2014;43(2):434-42.

Thomas R, Sanders S, Doust J, Beller E, Glasziou P. Prevalence of attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. Pediatrics. 2015;135(4):e994-1001.

Palacio-Ortiz JD, Peña-Quintero CE, Gómez-Valero MA, Bustamante-Gómez PA, Arroyave- Sierra PH, Vargas-Upeguí CD, et al. Trastornos psiquiátricos a través de la vida: un estudio de comparación de hijos de padres con trastorno afectivo bipolar tipo I frente a hijos de padres controles de la comunidad. Rev Colomb Psiquiatr. 2017;46(3):129-39.

Van Meerbeke AV, Gutiérrez CT, Reyes RG, Pinilla MI. Prevalencia de trastorno por déficit de atención con hiperactividad en estudiantes de escuelas de Bogotá, Colombia. Acta Neurol Colomb. 2008;24(1):6-12.

Orozco R, Vigo D, Benjet C, Borges G, Aguilar-Gaxiola S, Andrade LH, et al. Barriers to treatment for mental disorders in six countries of the Americas: A regional report from the World Mental Health Surveys. J Affect Disord. 2022;303:273-85.

Bará-Jiménez S, Vicuña P, Pineda D, Henao G. Perfiles neuropsicológicos y conductuales de niños con trastorno por déficit de atención/hiperactividad de Cali, Colombia. Rev Neurol. 2003;37(7):608-15.

Wolraich ML, Hagan JF, Allan C, Chan E, Davison D, Earls M, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4).

Atkinson M, Hollis C. NICE Guideline: Attention deficit hyperactivity disorder. Arch Dis Child - Educ Amp Pract Ed. 2010;95(1):24.

Weiss M, Childress A, Nordbrock E, Adjei AL, Kupper RJ, Mattingly G. Characteristics of ADHD symptom response/remission in a clinical trial of methylphenidate extended release. J Clin Med. 2019;8(4):461.

Roskell N, Setyawan J, Zimovetz E, Hodgkins P. Systematic evidence synthesis of treatments for ADHD in children and adolescents: indirect treatment comparisons of lisdexamfetamine with methylphenidate and atomoxetine. Curr Med Res Opin. 2014;30(8):1673-85.

Tamayo JM, Pumariega A, Rothe EM, Kelsey D, Allen AJ, Velez-Borras J, et al. Latino versus caucasian response to atomoxetine in attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2008;18(1):44-53.

Apiquián R, Córdoba R, Louza M, Fresán A. Electronic schizophrenia treatment adherence. Salud Ment. 2013;36(1):19-26.

Xochilcal-Morales M, Castro EM, Guajardo-Rosas J, Obregon T, Acevedo J, Chucan J, et al. A prospective, open-label, multicentre study of pregabalin in the treatment of neuropathic pain in Latin America. Int J Clin Pract. 2010;64(9):1301-9.

Lee YS, Lee JI, Takita Y, Takahashi M, Lee S. Efficacy and safety of atomoxetine hydrochloride in Korean adults with attention-deficit hyperactivity disorder. Asia-Pac Psychiatry. 2014;6:386-96.

Grau M. Análisis del contexto familiar en niños con tdah. Universitat de València; 2007.

Klassen AF, Miller A, Fine S. Health-related quality of life in children and adolescents who have a diagnosis of attention-deficit/hyperactivity disorder. Pediatrics. 2004;114(5):e541-7.

Chu K, Li S, Chen Y, Wang M. Family dynamics in families with children with attention déficit hyperactivity disorder. Shanghai Arch Psychiatry. 2012;24(5):279.

Pires T de O, Silva CMFP da, Assis SG de. Family environment and attention-deficit hyperactivity disorder. Rev Saúde Pública. 2012;46(4):624-33.

Moen ØL, Hedelin B, Hall-Lord ML. Family functioning, psychological distress, and well-being in parents with a child having ADHD. SAGE Open. 2016;6(1):2158244015626767.

Observatorio de Políticas de las Familias. [Internet] Tipologías de familias en Colombia: evolución 1993-2014. Disponible en: https://www2.congreso.gob.pe.

Tistarelli N, Fagnani C, Troianiello M, Stazi MA, Adriani W. The nature and nurture of ADHD and its comorbidities: A narrative review on twin studies. Neurosci Biobehav Rev. 2020;109:63-77.

Preuss U, Ralston SJ, Baldursson G, Falissard B, Lorenzo MJ, Pereira RR, et al. Study design, baseline patient characteristics and intervention in a cross-cultural framework: results from the ADORE study. Eur Child Adolesc Psychiatry. 2006;15(1):i4-14.

Pineda D, Puerta I, Merchan V, Arango C, Galvis A, Velasquez B, et al. Perinatal factors associated with attention deficit/hyperactivity diagnosis in Colombian Paisa children. Rev Neurol. 2003;36(7):609-13.

Fayyad J, De Graaf R, Kessler R, Alonso J, Angermeyer M, Demyttenaere K, et al. Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry. 2007;190(5):402-9.

Tarver J, Daley D, Sayal K. Attention-deficit hyperactivity disorder (ADHD): An updated review of the essential facts. Child Care Health Dev. 2014;40(6):762-74.

Wilens TE, Biederman J, Brown S, Tanguay S, Monuteaux MC, Blake C, et al. Psychiatric comorbidity and functioning in clinically referred preschool children and school-age youths with ADHD. J Am Acad Child Adolesc Psychiatry. 2002;41(3):262-8.

Artigas-Pallarés J. Comorbilidad en el trastorno por déficit de atención/hiperactividad. Rev Neurol. 2003;36(Supl 1):S68-78.

Rodríguez L, López J, Garrido M, Sacristán A, Martínez M, Ruiz F. Estudio psicométrico-clínico de prevalencia y comorbilidad del trastorno por déficit de atención con hiperactividad en Castilla y León (España). Pediatría Aten Primaria. 2009;11(42):251-70.

Polanczyk G, Rohde LA, Szobot C, Schmitz M, Montiel-Nava C, Bauermeister JJ. ADHD treatment in Latin America and the Caribbean. J Am Acad Child Adolesc Psychiatry. 2008;47(6):721-2.