Predictors of attention-deficit/hyperactivity disorder within 6 months after pediatric traumatic brain injury.
OBJECTIVE
To assess the phenomenology and predictive factors of attention-deficit/hyperactivity disorder (ADHD) after traumatic brain injury (TBI), also called secondary ADHD (SADHD).


METHODS
Children without preinjury ADHD 5-14 years old with TBI from consecutive admissions (n = 143) to five trauma centers were observed prospectively for 6 months (baseline and 6 months), with semistructured psychiatric interviews. Injury severity, lesion characteristics, and preinjury variables including psychiatric disorder, family psychiatric history, family psychiatric history of ADHD, family function, socioeconomic status, psychosocial adversity, and adaptive function were assessed with standardized instruments.


RESULTS
SADHD in the first 6 months after injury occurred in 18 of 115 (16%) of returning participants. All subtypes of ADHD occurred. Socioeconomic status (p = .041) and orbitofrontal gyrus lesions (p = .005) independently significantly predicted SADHD.


CONCLUSIONS
These findings are consistent with research on developmental ADHD that implicate psychosocial factors and prefrontal structural and functional differences between those with and without the disorder.
Max
Jeffrey E
JE
Department of Psychiatry, University of California, San Diego, USA. jmax@ucsd.edu
Schachar
Russell J
RJ
Levin
Harvey S
HS
Ewing-Cobbs
Linda
L
Chapman
Sandra B
SB
Dennis
Maureen
M
Saunders
Ann
A
Landis
Julie
J
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000209:etiology; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors