Clinical presentation of attention-deficit/hyperactivity disorder in preschool children: the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS).
OBJECTIVE
The aim of this study was to describe the clinical presentation of preschoolers diagnosed with moderate to severe attention-deficit/hyperactivity disorder (ADHD) recruited for the multisite Preschool ADHD Treatment Study (PATS). The diagnosis and evaluation process will also be described.


METHODS
A comprehensive multidimensional, multi-informant assessment protocol was implemented including the semistructured PATS Diagnostic Interview. Parent and teacher-report measures were used to supplement information from interviews. Consensus agreement by a cross-site panel on each participant's diagnoses was required. Analyses were conducted to describe the sample and to test associations between ADHD severity and demographic and clinical variables.


RESULTS
The assessment protocol identified 303 preschoolers (3-5.5 years) with moderate to severe ADHD Hyperactive/Impulsive or Combined type. The majority of participants (n = 211, 69.6%) experienced co-morbid disorders, with oppositional defiant disorder, communication disorders, and anxiety disorders being the most common. Participants with co-morbid communication disorders were found to be more anxious and depressed. ADHD severity was found to correlate with more internalizing difficulties and lower functioning. Although boys and girls had similar symptom presentations, younger children had significantly higher ADHD severity.


CONCLUSIONS
Preschoolers with moderate to severe ADHD experience high co-morbidity and impairment, which have implications for both assessment and treatment.
Posner
Kelly
K
New York State Psychiatric Institute/Columbia University, 1041 Riverside Drive, New York, NY 10032, USA. posnerk@childpsych.columbia.edu
Melvin
Glenn A
GA
Murray
Desiree W
DW
Gugga
S Sonia
SS
Fisher
Prudence
P
Skrobala
Anne
A
Cunningham
Charles
C
Vitiello
Benedetto
B
Abikoff
Howard B
HB
Ghuman
Jaswinder K
JK
Kollins
Scott
S
Wigal
Sharon B
SB
Wigal
Tim
T
McCracken
James T
JT
McGough
James J
JJ
Kastelic
Elizabeth
E
Boorady
Roy
R
Davies
Mark
M
Chuang
Shirley Z
SZ
Swanson
James M
JM
Riddle
Mark A
MA
Greenhill
Laurence L
LL
D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002652:Child Behavior; D002675:Child, Preschool; D003147:Communication Disorders / Q000150:complications / Q000523:psychology; D003627:Data Interpretation, Statistical; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012107:Research Design; D012309:Risk-Taking; D012959:Socioeconomic Factors; D014947:Wounds and Injuries / Q000453:epidemiology
D000697:Central Nervous System Stimulants; D008774:Methylphenidate