title: ADHD Prevalence in Spanish Preschoolers: Comorbidity, Socio-Demographic Factors, and Functional Consequences.
abstract: OBJECTIVE
  The object was to examine the prevalence of ADHD among preschoolers, analyzing comorbidity, and the association with socio-demographic factors.
  
  
  METHODS
  We conducted a two-phase epidemiological study of 1,104 preschoolers aged 3 to 6 years in Catalonia, Spain. The Early Childhood Inventory-4 (ECI-4) was administered to parents and teachers. Children at risk of ADHD were assessed using open-ended face-to-face interviews and were observed in a school setting. ADHD diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria.
  
  
  RESULTS
  The prevalence of ADHD diagnosis was 5.4%. Male sex and first-born status were risk factors for ADHD. Parents reported more symptoms (12.9%) than teachers (8.7%). Behavioral problems (odds ratio [OR] = 12, p = .001), autism spectrum disorder problems (OR = 9.5, p = .001), and obsessive-compulsive problems and tics (OR = 5.9, p = .001) were specifically related to ADHD diagnosis. Mother's health status and school achievement were lower in ADHD children.
  
  
  CONCLUSIONS
  Even at early stages of development, ADHD has high rates of comorbidity and a significant impact on school performance and family health.
authors.affiliation: 1 Rovira i Virgili University, Tarragona, Spain.
authors.forename: Josefa
authors.initials: J
authors.lastname: Canals
authors.affiliation: 1 Rovira i Virgili University, Tarragona, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Morales-Hidalgo
authors.affiliation: 2 Autonomous University of Barcelona, Spain.
authors.forename: M Claustre
authors.initials: MC
authors.lastname: Jané
authors.affiliation: 2 Autonomous University of Barcelona, Spain.
authors.forename: Edelmira
authors.initials: E
authors.lastname: Domènech
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D000067877:Autism Spectrum Disorder / Q000150:complications / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013981:Tic Disorders / Q000150:complications / Q000453:epidemiology
keywords: ADHD; comorbidity; epidemiology; preschool; prevalence