ADHD in a School Sample of Brazilian Adolescents: A Study of Prevalence, Comorbid Conditions, and Impairments

doi:10.1097/00004583-199906000-00019

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 38, Issue 6, June 1999, Pages 716-722

https://doi.org/10.1097/00004583-199906000-00019 Get rights and content

ABSTRACT

Objective

To evaluate the prevalence, comorbid conditions, and impairments of attention-deficit/hyperactivity disorder (ADHD) among young adolescents in Porto Alegre, Brazil.

Method

1,013 students aged 12 to 14 years were evaluated at 64 state schools, using a screening instrument based on the 18 DSM-IV ADHD symptoms. All positive screened students (n = 99) and a random subset of negative screened subjects (n = 92) had a psychiatric evaluation carried out within a hospital setting or at home.

Results

The prevalence of ADHD was estimated to be 5.8% (95% confidence interval = 3.2–10.6), and the comorbidity with other disruptive behavior disorders was high (47.8%). Youths with ADHD (n = 23) had significantly higher rates of school repetitions, suspensions, and expulsions (p <.01) than controls (n = 168). No association was identified between ADHD and alcohol, marijuana, and inhalant use.

Conclusion

The results extend to adolescents well-documented findings in children, indicating that ADHD is quite prevalent in early adolescence and affected youths are at high risk for impairment and dysfunction in multiple domains.

REFERENCES (41)

TM Achenbach et al.
Six-year predictors of problems in a national sample of children and youth
J Am Acad Child Adolesc Psychiatry
(1995)
B Applegate et al.
Validity of age-of-onset criterion for ADHD: a report from the DSM-IV field trials
J Am Acad Child Adolesc Psychiatry
(1997)
RA Barkley et al.
The adolescent outcome of hyperactive children diagnosed by research criteria, I: an 8-year prospective follow-up study
J Am Acad Child Adolesc Psychiatry
(1990)
A Baumgaertel et al.
Comparison of diagnostic criteria for attention deficit disorders in a German elementary school sample
J Am Acad Child Adolesc Psychiatry
(1995)
J Biederman et al.
Child Behavior Checklist findings further support comorbidity between ADHD and major depression in a referred sample
J Am Acad Child Adolesc Psychiatry
(1996)
J Biederman et al.
Predictors of persistence and remission of ADHD into adolescence: results from a four-year prospective follow-up study
J Am Acad Child Adolesc Psychiatry
(1996)
J Biederman et al.
Diagnostic continuity between child and adolescent ADHD: findings from a longitudinal clinical sample
J Am Acad Child Adolesc Psychiatry
(1998)
J Biederman et al.
Is ADHD a risk factor for psychoactive substance use disorders? Findings from a four-year prospective follow-up study
J Am Acad Child Adolesc Psychiatry
(1997)
DP Cantwell
Attention deficit disorder: a review of the past 10 years
J Am Acad Child Adolesc Psychiatry
(1996)
GJ DuPaul et al.
Does methylphenidate normalize the classroom performance of children with attention deficit disorder?
J Am Acad Child Adolesc Psychiatry
(1993)

SV Faraone et al.

A prospective four-year follow-up study of children at risk for ADHD: psychiatric, neuropsychological, and psychosocial outcome

J Am Acad Child Adolesc Psychiatry

(1996)

DM Fergusson et al.

Prevalence and comorbidity of DSM-III-R diagnoses in a birth cohort of 15 year olds

J Am Acad Child Adolesc Psychiatry

(1993)

M Gaub et al.

Gender differences in ADHD: a meta-analysis and critical review

J Am Acad Child Adolesc Psychiatry

(1997)

B Green et al.

The Children's Global Assessment Scale in clinical practice: an empirical evaluation

J Am Acad Child Adolesc Psychiatry

(1994)

RW Greene et al.

Toward a new psychometric definition of social disability in children with attention-deficit hyperactivity disorder

J Am Acad Child Adolesc Psychiatry

(1996)

BR Horner et al.

Prevalence and implications of attention-deficit hyperactivity disorder among adolescents in treatment for substance abuse

J Am Acad Child Adolesc Psychiatry

(1997)

PS Jensen et al.

Comorbidity in ADHD: implications for research, practice, and

DSM-IV. J Am Acad Child Adolesc Psychiatry

(1997)

R McGee et al.

DSM-III disorders in a large sample of adolescents

J Am Acad Child Adolesc Psychiatry

(1990)

S Milberger et al.

Is ADHD associated with early initiation of cigarette smoking in children and adolescents?

J Am Acad Child Adolesc Psychiatry

(1997)

DR Offord et al.

Integrating assessment data from multiple informants

J Am Acad Child Adolesc Psychiatry

(1996)

Cited by (203)

Can exposure to lisdexamfetamine dimesylate from juvenile period to peripubertal compromise male reproductive parameters in adult rats?
2024, Toxicology and Applied Pharmacology
Lisdexamfetamine (LDX) is a d-amphetamine prodrug used to treat attention deficit and hyperactivity disorder, a common neurodevelopmental disorder in children and adolescents. Due to its action mediated by elevated levels of catecholamines, mainly dopamine and noradrenaline, which influence hormonal regulation and directly affect the gonads, this drug may potentially disrupt reproductive performance. This study evaluated the effects of exposure to LDX from the juvenile to peripubertal period (critical stages of development) on systemic and reproductive toxicity parameters in male rats. Male Wistar rats (23 days old) were treated with 0; 5.2; 8.6 or 12.1 mg/kg/day of LDX from post-natal day (PND) 23 to 53, by gavage. LDX treatment led to reduced daily food and water consumption, as well as a decrease in social behaviors. The day of preputial separation remained unaltered, although the treated animals exhibited reduced weight. At PND 54, the treated animals presented signs of systemic toxicity, evidenced by a reduction in body weight gain, increase in the relative weight of the liver, spleen, and seminal gland, reduction in erythrocyte and leukocyte counts, reduced total protein levels, and disruptions in oxidative parameters. In adulthood, there was an increase in immobile sperm, reduced sperm count, morphometric changes in the testis, and altered oxidative parameters, without compromising male sexual behavior and fertility. These findings showed that LDX-treatment during the juvenile and peripubertal periods induced immediate systemic toxicity and adversely influenced reproductive function in adult life, indicating that caution is necessary when prescribing this drug during the peripubertal phase.
The role of the mother-child relationship in the route from child ADHD to adolescent symptoms of depressed mood
2017, Journal of Adolescence
We attempt to explain the co-variation between ADHD and symptoms of depressed mood, focusing on the family context and testing whether the mother-child relationship mediates or moderates the link between child ADHD and youth depressed mood symptoms. In a longitudinal study, we used mother and youth reports for 596 Swedish youth, 50% boys, from a community sample at 10, 15, and 18 years of age. The results did not support the mediation hypothesis. Only one moderation effect was found. Mother-child conflicts in mid-adolescence, as rated by mothers, increased symptoms of depressed mood symptoms in late adolescent only for youth with high levels of hyperactivity symptoms. However, depressed mood symptoms at age 18 were predicted by low mother-child involvement in mid-adolescence, over and above the effects of inattention symptoms. This latter finding was consistent across mother and youth ratings of the relationship. Implications of these results are discussed.
Social contextual risk factors for stimulant use among adolescent American Indians
2017, Drug and Alcohol Dependence
Stimulants are the most common and efficacious treatment for Attention-Deficit Hyperactivity Disorder (ADHD). We examined the relationship between stimulant misuse and social factors that could be malleable to prevention among American Indian (AI) adolescents.
Participants were AI students (N = 3498) sampled from 33 schools in 11 states. Participants completed the American Drug and Alcohol Survey. A multilevel analytic approach was used to evaluate the effects of participant-level (level 1) variables (i.e., gender, grade, peer, school, family, stimulant prescribed by doctor) on lifetime and current simulant use to ‘get high.’
Nearly 7% of our sample had been prescribed stimulants and nearly 6% of the sample reported using stimulants to get high. Age [OR = 1.22; 95% CI = 1.09, 1.36, p < 0.001], perception of peer substance use [OR = 1.19; 95% CI = 1.14, 1.23, p < 0.001], parental monitoring [OR = 0.96; 95% CI = 0.92, 1.99, p = 0.04], and stimulants prescribed by a doctor [OR = 8.79, 95% CI = 5.86, 13.18, p < 0.001] were associated with ever using stimulants to get high. Perception of peer substance use, [b = 0.09, SE = 0.02, p < 0.001, 95%CI [0.05, 0.13], and having stimulants prescribed by a doctor, [b = 0.58, SE = 0.21, p = 0.006, 95%CI [0.17, 0.99], were associated with frequency of past month use to get high. There was also a significant quadratic effect for parental monitoring, suggesting that low and high levels were associated with increased stimulant use.
Our results suggest a need for prevention efforts to be directed to AI youth who are prescribed stimulants.
Development, validation and comparison of two stability-indicating RP-LC methods using charged aerosol and UV detectors for analysis of lisdexamfetamine dimesylate in capsules
2016, Arabian Journal of Chemistry
Citation Excerpt :
Different prevalence rates reflect methodological differences (population sampled, study design, source of information, age, diagnostic criteria used, or how they are applied) more than cultural differences in diagnosis of the disorder. Using criteria of DSM-IV, the ADHD affects 3–6% of children around the globe (Faraone et al., 2003; Rohde et al., 1999). Stimulants are generally considered as first-line medication for the treatment of ADHD (Banaschewski et al., 2004).
Two new stability-indicating liquid chromatographic methods using two detectors, an ultraviolet (UV) and a charged aerosol detector (CAD) simultaneously connected in series were validated for the assessment of lisdexamfetamine dimesylate (LDX) in capsule. The method was optimized and the influence of individual parameters on UV and CAD response and sensitivity was studied. Chromatography was performed on a Zorbax CN column (250 mm × 4.6 mm, 5 μm) in an isocratic elution mode, using acetonitrile and 20 mM ammonium formate at pH 4.0 (50:50, v/v) as mobile phase and UV detection at 207 nm. The developed method was validated according to ICH guidelines and the parameters’ specificity, limit of detection, limit of quantitation, linearity, accuracy, precision and robustness were evaluated. CAD is designated to be a non-linear detector in a wide dynamic range, however, the method was linear over the concentration range of 70–130 μg mL⁻¹ in both detectors. The method was precise and accurate. Robustness study was performed by a Plackett–Burman design, delivering results within the acceptable range. Neither the excipients nor the degradation products showed interference in the method after studies of specificity as well as under stress conditions. The results of the LC-UV and LC-CAD methods were statistically compared through ANOVA and showed no significant difference (p > 0.05). Both proposed methods could be considered interchangeable and stability-indicating, and can be applied as an appropriate quality control tool for routine analysis of LDX in capsule.
Neurodevelopmental disorders among Spanish school-age children: prevalence and sociodemographic correlates
2022, Psychological Medicine
The relationship between exclusion from school and mental health: A secondary analysis of the British Child and Adolescent Mental Health Surveys 2004 and 2007
2018, Psychological Medicine

View all citing articles on Scopus

: This work was partially supported by a research fund of the Hospital de Clinicas de Porto Alege.

View full text

ORIGINAL ARTICLESADHD in a School Sample of Brazilian Adolescents: A Study of Prevalence, Comorbid Conditions, and Impairments

ABSTRACT

Objective

Method

Results

Conclusion

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

DSM-IV. J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

ORIGINAL ARTICLES
ADHD in a School Sample of Brazilian Adolescents: A Study of Prevalence, Comorbid Conditions, and Impairments