Clinical characteristics of attention-deficit/hyperactivity disorder in children and adolescents: association with quality of life and behavioral aspects

Oliveira, Marcone de Souza; Marinho, Mayke Felipe Dias; Lemos, Stela Maris Aguiar

doi:10.1590/1984-0462/2022/40/2020342

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Revista Paulista de Pediatria

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Original Article • Rev. paul. pediatr. 40 • 2022 • https://doi.org/10.1590/1984-0462/2022/40/2020342 copy

Clinical characteristics of attention-deficit/hyperactivity disorder in children and adolescents: association with quality of life and behavioral aspects

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Abstract

Objective:

To identify associations between clinical characteristics of children with attention-deficit/hyperactivity disorder (ADHD) and their sociodemographic aspects, quality of life, and results from the strengths and difficulties questionnaire.

Methods:

This is an observational analytical cross-sectional study with a non-probabilistic sample consisting of 72 children diagnosed with ADHD, aged 6 to 13 years, treated at 2 neuropediatric outpatient clinics. The instruments used were the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder – Swanson, Nolan, and Pelham, version IV (MTA-SNAP-IV), the Strengths and Difficulties Questionnaire (SDQ), the Brazilian Economic Classification Criteria (CCEB), and the Quality of Life Assessment Scale for Children and Adolescents (AUQEI). We performed descriptive, bivariate, and multivariate analyses, considering a 5% significance level.

Results:

SDQ results were associated with abnormal MTA-SNAP-IV results (inattentive/hyperactive/combined). A 1-point increment in the SDQ score increased by 36.5% the likelihood of the child having an abnormal MTA-SNAP-IV classification. Regarding AUQEI, 30.6% of participants perceived their quality of life as poor and 69.4% as good.

Conclusions:

A higher SDQ score increased the child's chance of having an abnormal MTA-SNAP-IV result.

Keywords:
Attention deficit disorder with hyperactivity; Quality of life; Comorbidity

Characteristics		MTA-SNAP-IV
		Inattentive	Hyperactive	Combined	Does not meet the criteria
		n (%)	n (%)	n (%)	n (%)
Sex
	Male	9 (60)	10 (83.3)	23 (74.2)	12 (85.7)
	Female	6 (40)	2 (16.7)	8 (25.8)	2 (14.3)
	Total	15 (100)	12 (100)	31 (100)	14 (100)
Age (years)
	6	1 (6.7)	1 (8.3)	1 (3.2)	0 (0)
	7	0 (0)	1 (8.3)	3 (9.7)	3 (21.4)
	8	1 (6.7)	2 (16.7)	6 (19.4)	0 (0)
	9	4 (26.7)	5 (41.7)	5 (16.0)	4 (28.6)
	10	4 (26.7)	1 (8.3)	6 (19.4)	2 (14.3)
	11	2 (13.3)	2 (16.7)	6 (19.4)	4 (28.6)
	12	3 (19.9)	0 (0)	3 (9.7)	0 (0)
	13	0 (0)	0 (0)	1 (3.2)	1 (7.1)
	Total	15 (100)	12 (100)	31 (100)	14 (100)
School grade
	1^st	0 (0)	1 (8.3)	1 (3.2)	0 (0)
	2^nd	0 (0)	1 (8.3)	3 (9.7)	2 (14.3)
	3^rd	1 (6.7)	3 (25)	6 (19.4)	2 (14.3)
	4^th	4 (26.7)	4 (33.4)	5 (16.1)	4 (28.6)
	5^th	5 (33.3)	1 (8.3)	8 (25.8)	2 (14.3)
	6^th	5 (33.3)	2 (16.7)	5 (16.1)	3 (21.4)
	7^th	0 (0)	0 (0)	3 (9.7)	1 (7.1)
	Total	15 (100)	12 (100)	31 (100)	14 (100)
CCEB
	A2	1 (6.7)	0 (0)	0 (0)	1 (7.1)
	B1	0 (0)	1 (8.3)	2 (6.7)	0 (0)
	B2	2 (13.3)	1 (8.3)	7 (22.6)	6 (42.9)
	C1	5 (33.3)	7 (58.3)	9 (30.0)	2 (14.3)
	C2	6 (60)	1 (8.3)	8 (25.8)	4 (28.6)
	D	1 (6.7)	2 (16.7)	5 (16.1)	1 (7.1)
	Total	15 (100)	12 (100)	31 (100)	14 (100)
Guardian's education level
	Incomplete elementary school	2 (13.3)	3 (25)	9 (30)	2 (14.3)
	Complete elementary school	1 (6.7)	2 (16.7)	4 (13.3)	1 (7.1)
	Incomplete high school	1 (6.7)	1 (8.3)	2 (6.7)	1 (7.1)
	Complete high school	9 (60)	3 (25)	14 (46.7)	8 (57.3)
	Complete higher education	2 (13.3)	3 (25)	1 (3.3)	1 (7.1)
	Graduate degree	0 (0)	0 (0)	0 (0)	1 (7.1)
	Total	15 (100)	12 (100)	31 (100)	14 (100)

		n	%
Current grade
	1^st to 4^th grade	37	51.4
	5^th to 7^th grade	35	48.6
	Total	72	100
CCEB
	A2/B1/B2	21	29.2
	C1/C2/D	51	70.8
	Total	72	100
Guardian's education level^* * n=71; CCEB: Brazilian Economic Classification Criteria; MTA-SNAP-IV: Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder – Swanson, Nolan, and Pelham, version IV.
	Incomplete/complete elementary school	29	40.8
	High school/higher education	42	59.2
	Total	71	100
MTA-SNAP-IV result
	Normal	14	19.4
	Abnormal	58	80.6
	Total	72	100

Characteristics		MTA-SNAP-IV
		Normal (n=14)	Abnormal (n=58)	p-value
		n (%)	n (%)	p-value
Sex
	Male	12 (85.7)	42 (72.4)	0.253
	Female	2 (14.3)	16 (27.6)	0.253
School grade
	1^st to 4^th	8 (57.1)	29 (50)	0.631
	5^th to 7^th	6 (42.9)	29 (50)	0.631
Guardian's education level
	Incomplete/complete elementary school	4 (28.6)	25 (43.9)	0.297
	High school/higher education	10 (71.4)	32 (56.1)	0.297
CCEB
	A2/B1/B2	7 (50)	14 (24.1)	0.060
	C1/C2/D	7 (50)	44 (75.9)	0.060
Quality of life
	Poor	4 (28.6)	18 (31)	0.567
	Good	10 (71.4)	40 (69)	0.567

	Abnormal MTA-SNAP-IV result
	Initial model			Final model
	OR	95%CI	p-value^* * Wald test	OR	95%CI	p-value^* * Wald test
CCEB – C1/C2/D	3.31	0.73 - 15.02	0.067	−	--	−
SDQ	1.38	1.14 - 1.16	0.001	1.36	1.14 - 1.,62	<0.001

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[1] *Corresponding author. E-mail: marconefarma@hotmail.com(M. S. Oliveira).