[The clinical semiology of attention deficit hyperactivity disorder according to age, and the effectiveness of treatments at different ages].
BACKGROUND
Attention deficit hyperactivity disorder (ADHD) is the most important cause of poor academic performance and is also usually associated with behavioural, emotional and sociability disorders.


OBJECTIVE
To analyse the different clinical features and the response to psychostimulant therapy, according to the age.


METHODS
We reviewed the cases of 152 children referred to Neuropaediatrics owing to suspected ADHD over a 6-year period. Diagnosis and comorbidity were investigated by the looking at their case history, by examination and observation, as well as by interviewing the parents (DSM-IV criteria), and by applying Conners' Rating Scale for parents and teachers, in addition to neuropsychological tests. In order to improve data processing, we established four groups according to the patient's age at diagnosis and when treatment was started: G1: 3-5; G2: 6-8; G3: 9-11; and G4: 12-15 years.


RESULTS
ADHD was diagnosed in 102 of the 152 children; 53% had the combined type, 26% were of the inattentional type, and 20% were hyperactive/impulsive. Poor school performance increased with age and reached 75% in G4. The same occurred with conduct disorders: at 6 years of age, 23% were found to have oppositional defiant disorder, and from the age of 9 onwards over 60% of them had conduct disorders. Up until 12 years of age they showed some improvement with psychostimulants and later the rate of dropouts from medical clinical controls and from treatment was over 40%.


CONCLUSIONS
The older patients are and the later ADHD is attended, the more problems they have. If successful preventive measures are to be implemented, it would be advisable to begin treatment even before children start primary education (5 years old), so as to try and avoid the pedagogical and behavioural repercussions observed in these children at the age of 6.
García-Pérez
A
A
Fundacion Hospital Alcorcon, 28922 Alcorcon, Espana.
Expósito-Torrejón
J
J
Martínez-Granero
M A
MA
Quintanar-Rioja
A
A
Bonet-Serra
B
B
D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D019955:Conduct Disorder / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010290:Parents; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies
D000697:Central Nervous System Stimulants