title: Attention-deficit hyperactivity disorder symptoms in children and adolescents with sex chromosome aneuploidy: XXY, XXX, XYY, and XXYY.
abstract: OBJECTIVE
  Attentional problems, hyperactivity, and impulsivity have been described as behavioral features associated with sex chromosome aneuploidy (SCA). In this study, the authors compare attention-deficit hyperactivity disorder (ADHD) symptoms in 167 participants aged 6 to 20 years with 4 types of SCA (XXY n = 56, XYY n = 33, XXX n = 25, and XXYY n = 53). They also evaluate factors associated with ADHD symptomatology (cognitive and adaptive scores, prenatal vs postnatal ascertainment) and describe the clinical response to psychopharmacologic medications in a subset of patients treated for ADHD.
  
  
  METHODS
  Evaluation included medical and developmental history, cognitive and adaptive functioning assessment, and parent and teacher ADHD questionnaires containing DSM-IV criteria.
  
  
  RESULTS
  In the total study group, 58% (96/167) met DSM-IV criteria for ADHD on parent-report questionnaires (36% in XXY, 52% in XXX, 76% in XYY, and 72% in XXYY). The Inattentive subtype was most common in XXY and XXX, whereas the XYY and XXYY groups were more likely to also have hyperactive/impulsive symptoms. There were no significant differences in Verbal, Performance, or Full Scale IQ between children with symptom scores in the ADHD range compared with those below the ADHD range. However, adaptive functioning scores were significantly lower in the group whose scores in the ADHD range were compared with those of the group who did not meet ADHD DSM-IV criteria. Those with a prenatal diagnosis of XXY were less likely to meet criteria for ADHD compared with the postnatally diagnosed group. Psychopharmacologic treatment with stimulants was effective in 78.6% (66/84).
  
  
  CONCLUSIONS
  Children and adolescents with SCA are at increased risk for ADHD symptoms. Recommendations for ADHD evaluation and treatment in consideration of other aspects of the SCA medical and behavioral phenotype are provided.
authors.affiliation: Neurodevelopmental and Behavioral Pediatrics, Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, 13123 East 16th Avenue, Aurora, CO, USA. Nicole.tartaglia@childrenscolorado.org
authors.forename: Nicole R
authors.initials: NR
authors.lastname: Tartaglia
authors.forename: Natalie
authors.initials: N
authors.lastname: Ayari
authors.forename: Christa
authors.initials: C
authors.lastname: Hutaff-Lee
authors.forename: Richard
authors.initials: R
authors.lastname: Boada
mesh_terms: D000293:Adolescent; D041923:Adolescent Development / Q000502:physiology*; D000328:Adult; D000782:Aneuploidy; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000209:etiology; D002648:Child; D002657:Child Development / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011296:Prenatal Diagnosis; D011569:Psychiatric Status Rating Scales; D012729:Sex Chromosome Aberrations; D058670:Tetrasomy / Q000503:physiopathology; D014314:Trisomy / Q000503:physiopathology; D014888:Wechsler Scales; D014997:XYY Karyotype / Q000503:physiopathology; D055815:Young Adult