Suggestive diagnosis of attention-deficit/hyperactivity disorder in indigenous children and adolescents from the Brazilian Amazon

Abstract

The prevalence of attention-deficit/hyperactivity disorder (ADHD) symptoms has been scarcely studied in indigenous cultures that preserve ancestral cultural characteristics. The objective of the study is to estimate the prevalence of suggestive diagnosis of ADHD among indigenous children and adolescents from villages in the Amazon. This is an analytical crosssectional study using instruments to track ADHD symptoms (the Child Behaviour Checklist for ages 6-18: CBCL/6-18 and the teacher report form for ages 6-18: TRF/6-18) and to investigate their negative impact on the patients (using the Strengths and Difficulties Questionnaire-SDQ). The prevalence of a suggestive ADHD diagnosis according to the CBCL/TRF DSM-IV ADHD subscale without and with negative impact as assessed by the SDQ was 4.3% and 1.1%, respectively. Comorbid oppositional-defiant, conduct problems and anxious symptoms were present in all cases screening positive for ADHD. We also presented a case report as an illustration of the observed clinical presentation. ADHD is a recognizable disorder even in a culture that preserves millennial characteristics. Furthermore, the presence of ADHD symptoms was associated with significant impairment.

Duzentos anos da proclamação da Independência do Brasil e alguns traços da personalidade e comportamento de D. Pedro I

“…É difícil, porém, atestar até que ponto tais comportamentos refletiam a adaptação de um lusitano ao ambiente tropical e sensual do Rio de Janeiro, extremamente convidativo para novas aventuras e folguedos de toda sorte. Por fim, devemos lembrar que o fenótipo de TDAH na infância pode representar na verdade uma apresentação do transtorno bipolar naquela fase da vida [28]. Alguns autores levantam, desta forma, a possibilidade de uma personalidade hipertímica para D. Pedro I [8].…”

Internal consistency of the Strengths and Difficulties Questionnaire in Amazonian children

“…It is easy to implement and, when prior training is provided to users, a specialized professional is not required 8 . Furthermore, as the scientific community extensively uses the SDQ, results can be compared between national and international studies 9 , 10 .…”

“…Sua implementação é fácil e quando os usuários recebem treinamento prévio, não há necessidade de profissionais especializados 8 . Além disso, considerando a utilização extensa do SDQ pela comunidade científica, os resultados podem ser comparados com estudos nacionais e internacionais 9 , 10 .…”

Key demographic and mental disorder diagnostic differences between Australian First Nations and non-First Nations clinic-referred children and adolescents assessed in a culturally appropriate and safe way

“…There are a number of methodological issues specifically linked to defining mental disorders in a cultural context: For example, a wide range of point prevalences for ADHD have been reported in Canadian First People (Baydala et al, 2006) (22.7%) and Brazilian First Nations (Azevedo et al, 2020) (1.1%) community samples, with comorbid ODD, CD and anxiety symptoms in the latter sample, using gold standard ADHD psychometric measures in non- First Nations populations, but without validity and reliability data for the respective First Nations young people. Other authors have noted that the variability of mental disorders point prevalence rates is reduced when the cultural variation of the countries sampled are limited (Canino et al, 2010) and First Nations specific understandings of Western constructs of ADHD, ODD, CD and anxiety/depressive disorders are ascertained (Betancourt et al, 2009).…”