Background: Attention deficit and hyperactivity disorder (ADHD) has a high prevalence and is frequently associated with comorbid illnesses.Objective: To assess the comorbid patterns, sociodemographic profiles, management patterns and outcomes amongst children with ADHD presenting to the Child and Adolescent Mental Health Services at the Lady Ridgeway Hospital for Children. Method:Two hundred patients, aged 6-12 years, diagnosed with ADHD, were assessed for their demographic features and comorbidities based on DSM IV criteria. Results:Of the 200 children, 166 (83%) were male and 198 (99%) were schooling. While 108 (54%) had a single neuropsychiatric comorbidity, 30 (15%) had 2 comorbidities and 1 (0.5%) had 3 comorbidities. Specific developmental disorder of scholastic skills (SDDSS) was the most prevalent comorbidity and was seen in 90 (45%) patients. Oppositional defiant disorder (ODD) was seen in 56 (28%) children and 17 (8.5%) had both SDDSS and ODD. In the sample, 90% of children were born of uneventful deliveries. Postnatal complications were found in 12% children. In the sample, 30% had a history of febrile fits and 2.5% had a history of afebrile fits. Conclusions:In this sample of 200 children with diagnosed ADHD, 139 (69.5%) had one or more neuropsychiatric comorbidities. SDDSS was the most prevalent comorbidity ___________________________________________
IntroductionPrevious optimistic assumptions about the prognosis of BAD based on the control of mood symptoms is now challenged as majority of patients continue to have cognitive deficits during the euthymic phase.ObjectivesTo describe cognitive impairment in euthymic BAD and study the association with clinical characteristics.AimsIdentify the prevalence and severity of cognitive impairment (CI); to correlate CI with the first episode, illness duration, number of episodes and predominant polarity.MethodsPatients attending the psychiatry clinic of the National Hospital of Sri Lanka diagnosed with BAD in the remission phase were recruited. An interviewer-administered questionnaire and Montreal Cognitive Assessment test was used to ascertain clinical characteristics and cognitive functions respectively. Scores of 18–26 described as mild, 10–17 moderate and < 10 as severe cognitive impairment.ResultsTotal sample size was 58. Mean age = 48.84 (SD12.5). Fifty-five percent were females. Mean duration of illness was 179.7 months (SD128.5). A mean of 6 episodes were experienced during the course of illness (min = 1, max = 18); 58.6% had depression, 37.9% had manic and 3.4% had mixed as their first episode. The predominant polarity was depressive in 65.5%. No cognitive impairment – 8.6%, mild – 63.8%, moderate – 27.6% and none with severe. There was a significant association between the presence of cognitive impairment and the predominant polarity being depressive (r = 10.886, df = 4, P = 0.028). No significant association was found between illness duration, number of episodes or the type of first episode.ConclusionsPatients with a predominant depressive polarity are more likely to experience cognitive impairment. Cognitive impairment had no association with illness duration, type of episode or number of episodes.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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