Predictors of diagnostic delay in a clinical sample of French children with attention-deficit/hyperactivity disorder.
BACKGROUND
Early recognition of attention-deficit/hyperactivity disorder (ADHD) may improve the educational and psychosocial outcome of most affected children. To date, factors associated with diagnostic delay of ADHD have not specifically been addressed. Aims of this study were to evaluate the mean diagnostic delay (time between first consultation and definite diagnosis) in a clinical sample of French children with ADHD referred to an outpatient university clinic, and to determine associated factors.


METHODS
A total of 129 consecutively referred ADHD patients aged 6-16 years. A detailed history of the children was obtained from their parents. The Kiddie-SADS-PL, the ADHD-Rating Scale, and the Clinical Global Impression Scale were used for clinical assessment.


RESULTS
Mean diagnostic delay was 32.89 months. A previous suspicion of ADHD by any health care professional, therapist or teacher was significantly associated with a reduced diagnostic delay. Co-morbidity with anxiety/depressive disorders and previous contact with a mental health professional were associated with a significant delay in diagnosis.


CONCLUSIONS
Delay in diagnosis of ADHD in France is among the longest reported. Children with co-morbid anxiety or depressive disorders are particularly at risk of having a significant delay in the diagnosis. Health professionals, therapists and teachers may play a relevant role to accelerate the diagnostic procedure.
Purper-Ouakil
D
D
AP-HP, Hôpital Robert Debré, Paris, France. diane.ouakil-purper@wanadoo.fr
Cortese
S
S
Wohl
M
M
Asch
M
M
Acquaviva
E
E
Falissard
B
B
Michel
G
G
Gorwood
P
P
Mouren
M C
MC
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis*; D002648:Child; D042241:Early Diagnosis; D005260:Female; D005602:France; D006301:Health Services Needs and Demand; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013997:Time Factors