Attention-deficit hyperactivity disorder in elementary school students in Shantou, China: prevalence, subtypes, and influencing factors

Huang, Yanhong; Shao-xiong, Zheng; Xu, Chongtao; Lin, Kun; Wu, Kusheng; Zheng, Maochun; Zhang, Jie; Xu, Haiyun

doi:10.2147/ndt.s126100

Cited by 24 publications

(35 citation statements)

References 42 publications

(51 reference statements)

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“…As controls, typically developing children from these same schools were randomly selected and matched according to gender and age to the cases. A two-stage screening procedure to diagnose children with ADHD was described in detail in our previous publication, 3 and shown in Figure S1 . Children with major physical diseases, bipolar disorder, psychotic disorder, and other severe psychiatric disorders were excluded.…”

Section: Methodsmentioning

confidence: 99%

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Involvement of family environmental, behavioral, and social functional factors in children with attention-deficit/hyperactivity disorder

Huang

et al. 2018

PRBM

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BackgroundThe objective of this study was to investigate relationships among family environmental characteristics, behavior problems, and social function impairments in children with ADHD.MethodsAmong children from four primary schools in Shantou city of China, 132 who were diagnosed with ADHD were selected and 138 typically developing children were recruited from the same schools. These children were evaluated using the self-designed questionnaire, FES-CV, CPRS, CTRS, and WFIRS-P for familial environment, behavioral problems, and social function impairment measures. In addition, children’s behavioral problems and functional impairments were evaluated using self-established field behavior observation method. Logistic regression model was used to estimate ORs and 95% CIs for ADHD risk with family environmental factors.ResultsIn the unconditional logistic model, ADHD risk in children was increased with parents’ worse educational level, occupational status, and emotional stability with trend. Children with ADHD had lower scores on most subscales of FES-CV (P<0.01) but higher scores on Conflict subscale (P<0.001). Children with ADHD showed impairments on all the six WFIRS-P subscales tests (all P<0.001), and higher scores on the CPRS and CTRS scale subscales representing behavioral symptoms (all P<0.001 except Somatic Complaints), and more behavioral problems and functional impairments.ConclusionCompared with typically developing children, children with ADHD had worse family environment. Family characteristics especially parents’ emotional unstability, lower education levels, and worse occupation status may increase ADHD risk in children. In addition, the behavioral problems and social functional impairments may interact with adverse family environmental factors in children with ADHD. Therefore, early interventions with focus onto the compromising factors can be useful for improving the social-behavioral functions of children with ADHD.

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Section: Methodsmentioning

confidence: 99%

“… 2 The prevalence according to the criteria of DSM-5 is around 6% in China as well as in Shantou city. 3 …”

Section: Introductionmentioning

confidence: 99%

Involvement of family environmental, behavioral, and social functional factors in children with attention-deficit/hyperactivity disorder

Huang

et al. 2018

PRBM

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“…It assesses ADHD symptoms on a 4-point scale ranging from 0 to 3. It discriminates very well between children with and without ADHD and therefore has been used as a valid screening instrument for the identification and measurement of the behavioral problems of ADHD among children in China [ 19 ]. The total score is coded into a categorical variable, with a score ≥ 15 representing high levels of ADHD symptoms.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of attention-deficit/hyperactivity disorder symptoms and their associations with sleep schedules and sleep-related problems among preschoolers in mainland China

Cao

Yan

et al. 2018

BMC Pediatr

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BackgroundAttention-deficit/hyperactivity disorder (ADHD) among children is an increasing public health concern. The identification of behavioral risk factors, including sleep quality, has important public health implications for prioritizing behavioral intervention strategies for ADHD. Herein, this study aimed to investigate the prevalence of high levels of ADHD symptoms and to explore the association between sleep schedules, sleep-related problems and ADHD symptoms among preschoolers aged 3 to 6 years in mainland China.MethodsA cross-sectional study was conducted, comprising a large sample of 15,291 preschoolers in Ma’anshan city of Anhui Province in China. ADHD symptoms were assessed by the 10-item Chinese version of the Conners Abbreviated Symptom Questionnaire (C-ASQ). Sleep-related variables included caregivers’ responses to specific questions addressing children’s daytime and nighttime sleep schedules, as well as sleep-related behaviors. Data on other factors were also collected, such as socio-demographic characteristics, TV viewing duration on weekdays and weekends, and outdoor activities. Logistic regression models were used to analyze the relationships between sleep schedules, sleep-related problems and ADHD symptoms.ResultsApproximately 8.6% of the total sample of preschoolers had high levels of ADHD symptoms, with boys having higher levels than girls (9.9% vs. 7.2%). In the logistic regression analysis, after adjusting for TV viewing duration, outdoor activities, and socio-demographic characteristics, delayed bedtime was significantly associated with a risk of high levels of ADHD symptoms, with odds ratios (OR) of 2.50 [95% confidence interval (CI): 2.09 ~ 3.00] and 2.04 (95% CI: 1.72 ~ 2.42) for weekdays and weekends, respectively. Longer time falling asleep (≥ 31 min) (OR = 1.76, 95% CI: 1.47 ~ 2.11), no naps (OR = 1.57, 95% CI: 1.34 ~ 1.84) and frequent sleep-related problems (OR = 4.57, 95% CI: 3.86 ~ 5.41) were also significantly associated with an increased risk of high levels of ADHD symptoms, while longer sleep duration (> 8.5 h) was associated with a decreased risk of high levels of ADHD symptoms (OR = 0.76, 95% CI: 0.67~ 0.87).ConclusionsADHD symptoms are prevalent in preschoolers in Ma’anshan region, China. Undesirable sleep schedules and sleep-related problems among preschoolers confer a risk of ADHD symptoms, highlighting the finding that beneficial and regular sleep habits potentially attenuate ADHD symptoms among preschoolers.

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“…This result further refines conclusions from previous voxel-based morphometry studies in which authors reported reduced gray matter in the motor and premotor cortices (38) There were several limitations of this study that need to be taken into account when interpreting the data. First, because of the low prevalence of the hyperactive impulsive subtype of ADHD in China (49) and our restrictive inclusion criteria, individuals with this subtype were not included in our study. Second, children of a fairly large age range who were at different stages of their developmental trajectories participated in our study.…”

Section: Figurementioning

confidence: 99%

Psychoradiologic Utility of MR Imaging for Diagnosis of Attention Deficit Hyperactivity Disorder: A Radiomics Analysis

Sun¹,

Chen²,

Huang³

et al. 2018

Radiology

130

133

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Purpose To identify cerebral radiomic features related to diagnosis and subtyping of attention deficit hyperactivity disorder (ADHD) and to build and evaluate classification models for ADHD diagnosis and subtyping on the basis of the identified features. Materials and Methods A consecutive cohort of 83 age- and sex-matched children with newly diagnosed and never-treated ADHD (mean age 10.83 years ± 2.30; range, 7-14 years; 71 boys, 40 with ADHD-inattentive [ADHD-I] and 43 with ADHD-combined [ADHD-C, or inattentive and hyperactive]) and 87 healthy control subjects (mean age, 11.21 years ± 2.51; range, 7-15 years; 72 boys) underwent anatomic and diffusion-tensor magnetic resonance (MR) imaging. Features representing the shape properties of gray matter and diffusion properties of white matter were extracted for each participant. The initial feature set was input into an all-relevant feature selection procedure within cross-validation loops to identify features with significant discriminative power for diagnosis and subtyping. Random forest classifiers were constructed and evaluated on the basis of identified features. Results No overall difference was found between children with ADHD and control subjects in total brain volume (1069830.00 mm ± 90743.36 vs 1079 213.00 mm ± 92742.25, respectively; P = .51) or total gray and white matter volume (611978.10 mm ± 51622.81 vs 616960.20 mm ± 51872.93, respectively; P = .53; 413532.00 mm ± 41 114.33 vs 418173.60 mm ± 42395.48, respectively; P = .47). The mean classification accuracy achieved with classifiers to discriminate patients with ADHD from control subjects was 73.7%. Alteration in cortical shape in the left temporal lobe, bilateral cuneus, and regions around the left central sulcus contributed significantly to group discrimination. The mean classification accuracy with classifiers to discriminate ADHD-I from ADHD-C was 80.1%, with significant discriminating features located in the default mode network and insular cortex. Conclusion The results of this study provide preliminary evidence that cerebral morphometric alterations can allow discrimination between patients with ADHD and control subjects and also between the most common ADHD subtypes. By identifying features relevant for diagnosis and subtyping, these findings may advance the understanding of neurodevelopmental alterations related to ADHD. RSNA, 2017 Online supplemental material is available for this article.

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Attention-deficit hyperactivity disorder in elementary school students in Shantou, China: prevalence, subtypes, and influencing factors

Cited by 24 publications

References 42 publications

Involvement of family environmental, behavioral, and social functional factors in children with attention-deficit/hyperactivity disorder

Involvement of family environmental, behavioral, and social functional factors in children with attention-deficit/hyperactivity disorder

Prevalence of attention-deficit/hyperactivity disorder symptoms and their associations with sleep schedules and sleep-related problems among preschoolers in mainland China

Psychoradiologic Utility of MR Imaging for Diagnosis of Attention Deficit Hyperactivity Disorder: A Radiomics Analysis

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