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You are assessing a 7 year old boy with attention and behaviour difficulties, and poor school performance. He has an average IQ and meets the diagnostic criteria for attention deficit hyperactivity disorder (ADHD). There is no evidence of developmental delay, dysmorphism, or other physical abnormalities and no relevant family history. Parents are keen on investigation for a “cause” for his problems. You are aware that some chromosomal and cytogenetic abnormalities may be associated with ADHD. You wonder if you should check karyotype and look for cytogenetic abnormalities with genetic implications for the family.
Structured clinical question
Should children with ADHD and normal intelligence [subject] be routinely screened* [intervention] for underlying cytogenetic abnormalities [outcome with genetic implications]?
Search strategy and outcome
OVID Medline and EMBASE search: “ADHD” AND (“cytogenetics” OR “human chromosomes”). A total of 61 articles were obtained combining these searches. After searching abstracts, 10 relevant articles were retrieved. (The remainder were mainly …