To survey the clinical features of children with attention deficit hyperactivity disorder when they were first examined at Danang Psychiatric Hospital and find out a number of factors related to child hyperactivity disorder. Subjects and methods: Cross-sectional study on 132 children from 6 - 10 years old, who were diagnosed with attention deficit hyperactivity disorder when they were first examined at Danang Psychiatric Hospital. Results: The rate of children with attention deficit disorder was 80.3%, hyperactivity disorder was 36.4%, increased attention deficit hyperactivity disorder was 53.0%, the incidence of male infants was not different from that of female infants. 6 years old had the highest disease and 10 years old was the lowest. Conclusion: Infants with attention deficit hyperactivity disorder should be interfered with by behavioral and focus attention training.
Journal of military pharmaco-medicine n02-2019 RESEARCH ON THE CLINICAL FEATURES OF CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER SEE THE DOCTORS IN THE FIRST TIME AT DANANG PSYCHIATRIC HOSPITAL Tong Thi Luyen1; Nguyen Thi My Anh1 Nguyen Thi Hoai Thuong1 SUMMARY Objectives: To survey the clinical features of children with attention deficit hyperactivity disorder when they were first examined at Danang Psychiatric Hospital and find out a number of factors related to child hyperactivity disorder Subjects and methods: Cross-sectional study on 132 children from - 10 years old, who were diagnosed with attention deficit hyperactivity disorder when they were first examined at Danang Psychiatric Hospital Results: The rate of children with attention deficit disorder was 80.3%, hyperactivity disorder was 36.4%, increased attention deficit hyperactivity disorder was 53.0%, the incidence of male infants was not different from that of female infants years old had the highest disease and 10 years old was the lowest Conclusion: Infants with attention deficit hyperactivity disorder should be interfered with by behavioral and focus attention training * Keywords: Attention deficit hyperactivity disorder; Children; Psychiatric INTRODUCTION Increased attention deficit hyperactivity disorder causes serious consequences, effects adverse on the psychological development and personality of the child These children are often overactive, difficult to control, impulsive, accident prone The incidence about attention deficit hyperactivity disorder of the American Psychiatric Association was 7.2% In Danang, children with attention deficit hyperactivity disorder (ADHD) have paid to medical examination and treatment at Danang Psychiatric Hospital is increasing Clinical manifestations are rich and complex Therefore, we carry out this topic with aims: Survey clinical features of children with ADHD when they were first examined at Danang Psychiatric Hospital and to find out factors related to ADHD SUBJECTS AND METHODS Subjects 132 children came to the first time at Danang Psychiatric Hospital * Selection criteria: Children between and 10 years of age with ADHD, determined according to DSM-IV, children whose parents are willing to participate in the study * Exclusion criteria: Parents not cooperate Insufficient answers in the questionnaire Children have been diagnosed with autism, depression, schizophrenia, anxiety, mood disorders Danang Psychiatric Hospital University of Medicine Technology and Pharmacy Corresponding author: Nguyen Thi My Anh (nephuong2007@gmail.com) Date received: 20/12/2018 Date accepted: 18/01/2019 156 Journal of military pharmaco-medicine n02-2019 Methods A cross-sectional descriptive study * Sample size design: Children from to 10 years old for first visit to Danang Psychiatric Hospital diagnosed with dynamic disorder by DSM-IV * Sampling method: Choose a convenient template * Rating tool: Use a prepared form and Vanderbilt ADHD Diagnostic Screening Scale * Time and place of study: From - 2018 to 10 - 2018 at Danang Psychiatric Hospital * Ethics: Parents agree to voluntarily participate in the study and have the right to withdraw from the study without having to explain the reasons, the information provided by the researcher is kept confidential RESULTS Clinical feature of children with ADHD * General characteristics: Table 1: Prevalence and sex Sex Ages Male Female Total n % n % n % years 36 37.5 10 27.78 46 34.84 years 21 21.87 25 30 22.73 years 17 17.71 19.44 24 18.18 years 12 12.5 16.67 18 13.64 10 years 10 10.42 11.11 14 10.6 Total 96 72.73 36 27.27 132 100 Mean age: 7.42 ± 1.19; male/female: 2.7/1 The rate of male children was (72.73%) higher than female 2.7 times Children at the age of had the highest rate (34.84%) and the lowest age was 10 years (10.60%) * Characteristics of family circumstances: The children had parents living together was 93.9% (124 children), parents separated or divorced was 6.06% (8 children) 157 Journal of military pharmaco-medicine n02-2019 * Obstetric history: Table 2: Subjects n % Normal 98 74.24 Severe pregnancy/threatened miscarriage 15 11.37 Mother had accompanying entity 5.30 Mother had psychological trauma 12 9.09 Normal birth 75 56.8 Sesame/intervention tricks 39 29.6 Preterm birth 6.1 Abnormal at birth 10 7.6 Obstetric history Mother‟s process is pregnant Process of birth * The incidence of ADHD: 90 80 70 60 50 40 30 20 10 80.3% 53% 36.4% Chart 1:disorder Prevalenceattention of children who have increased ADHD Hyperactivity deficit disorder ADHD Hyperactivity disorder was the highest (36.4%), attention deficit disorder was 80.3%, increase in ADHD was 53% * Sex and percentage of children with ADHD: Table 3: Sex and percentage of children with ADHD Male (n = 96) Sex Female (n = 36) Disorders n % n % Hyperactivity disorder (HD) 38 39.6 10 27.8 Attention deficit disorder (AD) 78 81.2 28 77.8 Coordinated disorder (ADHD) 53 55.2 17 47.2 p > 0.05 Percentages of male had hyperactivity disorder was (39.6%) higher than female (27.8%) Attention deficit disorder of female was (81.2%) higher than male, however, it‟s only the differences in numbers, but it was not statistical differences 158 Journal of military pharmaco-medicine n02-2019 * Distribution of age and percentage of children with ADHD: Table 4: The percentages of children with the disorder and ages Clinical feature Age Attention deficit disorder Hyperactivity disorder Coordinated disorder F % F % F % years 41 89.1 21 45.7 26 56.5 years 25 83.3 11 36.7 18 60 years 18 75 33.3 13 54.2 years 13 72.2 27.8 27.8 10 years 64.3 21.4 57.1 p > 0.05 The years old children with attention deficit disorder was the highest (89.1%) and the lowest was 10 years old (64.3%) The years old children with hyperactivity disorder was the highest (45.7%) and the lowest was 10 years old (21.4%) The years old children with ADHD was the highest (60.0%) and the lowest was years old (27.8%) * Clinical features of children with ADHD: - The symptoms of attention deficit disorder: Table 5: Clinical features of attention deficit disorder n = 132 The expression of attention deficit disorder Mean SD Do not pay attention to the details/mistakes on the job 1.57 497 Difficult to sustain attention in tasks/activities 1.58 495 Easily distracted by external stimuli 1.64 481 Forgetful in daily activities 1.24 430 Symptoms such as easily distracted by external stimuli of attention deficit disorder was the highest (1.64) and next difficult to sustain attention in tasks/activities (1.58) - The symptoms of hyperactivity disorder: Table 6: Clinical features of hyperactivity disorder n = 132 The expression of hyperactivity disorder Mean SD Wiggle or squirm limbs and fidgety 1.39 489 Difficulty playing or participating in static activities 1.38 487 Activities always limbs or act as "motor" 1.38 487 Said cut /interrupts work/conversation of others 0.96 670 159 Journal of military pharmaco-medicine n02-2019 Symptoms such as Wiggle or squirm limbs and fidgety was the highest (1.39) and next difficulty playing or participating in static activities, activities always limbs or act as "motor" (1.38) Factors related to the proportion of children with ADHD, * Relationship between the place of living and the rate of children with ADHD: Table 7: Clinical AD HD ADHD Total n (%) n (%) n (%) n (%) Rural 73 (78.5) 31 (33.3) 46 (49.5) 93 (70.5) Urban 33 (84.6) 17 (43.6) 24 (61.5) 33 (29.5) Local p > 0.05 There was no difference in incidence between rural and urban (p > 0.05) However, considering the numbers, children living in city had attention deficit disorder higher than children living in rural (84.6%) * Relationship between obstetric history and the rate of children with ADHD: Table 8: AD HD ADHD n (%) n (%) n (%) Normal 78 (79.6) 31 (31.6) 46 (46.9) Severe pregnancy/threatened miscarriage 13 (86.6) (33.3) (60.0) Mother have accompanying entity (85.7) (57.1) (71.4) Mother have psychological trauma (75.0) (66.7) 10 (83.3) Normal birth 62 (82.7) 26 (34.7) 40 (53.3) Sesame/intervention tricks 32 (82.1) 14 (35.9) 19 (48.7) Preterm birth (75.0) (25.0) (50.0) Abnormal at birth (60.0) (60.0) (70.0) Clinical features Obstetric history Pregnancy (p > 0.05) The process of birth (p > 0.05) There was no difference in children affected with obstetric history of young mother (p > 0.05) 160 Journal of military pharmaco-medicine n02-2019 DISCUSSION Clinical features - The attention deficit disorder had the highest rate (80.3%), ADHD disorder had rate of 53.0%, and the lowest was hyperactivity disorder (36.4%) This result was similar to Xiao H.Z et al‟s study; of the 196 children with ADHD, children with AD, the rate of 42.8%, with HD, the rate was 17.8% and ADHD was 39.4% [10] Yuki's study on 69 children who was diagnosed with ADHD showed 29 children with AD accounted for 42.0%, HD was 17.4% [8] - Sex: Percentage of boys with AD was higher than girls (81.2%), percentage of girls with HD was lower than boys (36.4%) These results were similar to results of Nguyen The Manh: percentage of boys with ADHD was 70.3% [1] Fleck‟s study in Australia on 144 children showed boys accounted for 73.6%, the rate of boy with ADHD disorder was higher than that of girls, because male gender characteristics often take "breakthrough" action, more active, but more psychological trauma, beside, it was also possible to explain biological theory of gender differences of mental disorders depends on the role of sex hormones [5, 9] - Age: The most common disorder was attention deficit, the most common age was years old, accounted for 89.1% Next, years old accounted for 83.3% Percentage of children with HD was high and the highest at age 6, accounting for 45.7% The lowest age was 10 years, accounting for 21.4% With ADHD, the highest at age years, accounting for 60.0% The lowest age was years, accounting for 27.8% Symptoms of ADHD when children appear from years old However, parents thought their children weren‟t hyperactive so they did not take their child to the doctor, until the child entered grade 1, children went to school without concentration, they run a lot and didn‟t comply with the rules of the class or the school, affect classmates, this children were often complained by teachers, so parents should take their children to the clinic - This study‟s results were also consistent with study by Nguyen The Manh at Children's Hospital Central on 38 child with ADHD who usually started preschool age to years [1] The stage most clearly manifested the symptoms of ADHD were about - years old Extensive epidemiological studies in countries about ADHD in recently years showed that - 12 years old children had percentage of disorder were the highest in populations Wang L.J, Lee S.Y‟s study had conducted over 415,018 children under 18 years of age in Taiwan in 11 years showed that percentage of disorder increased continuously over time and - 12 years old children had percentage of disorder with the highest than age group under years old and 13 to 18 years old [6] Factors related to ADHD - Obstetric history: Mackie S, Shaw.P said that cases of acute oxygen as well as 161 Journal of military pharmaco-medicine n02-2019 chronic in woman‟s pregnancy were associated with increased risk of ADHD later The correlation with the occurrence of ADHD also be found in cases of premature birth or abnormal umbilical cord at birth [7] In our study, the results didn‟t reflect the relationship between family structure, pregnancy and childbirth with unusual factors affecting the child This may be due to the small sample size - Living place: No correlation between place living and the child's morbidity rate However, children living in urban had the highest AD rate (84.6%/93), HD was 43.6%/39; ADHD was 61.5% For children living in urban, their parents receiving knowledge through information channels quickly and soon So that, parents and teachers discovered children with abnormalities and take them to examine, however, parents in rural areas thought that their children with this disorder was normal CONCLUSION * Clinical features of children with ADHD: - The attention deficit disorder had the highest rate (80.3%), ADHD disorder had rate of 53.0%, hyperactivity disorder was 36.4% - Percentage of boys with AD disorder were 81,2%, percentage of girls with HD disorder was 36.4% - Children years old had attention deficit disorder accounting for 89.1% and the lowest was 10 years old (64.3%) 162 With HD disorder, the highest at age years old, accounting for 45.7% The lowest age was 10 years old, accounting for 21.4% - With HD, the symptoms as Wiggle or squirm limbs and fidgety was the highest, with disorder AD, symptom such as easily distracted by external stimuli was the highest * Related factors: - Children living in city had attention deficit disorder 84.6%, hyperactivity disorder 43.6% and ADHD disorders 61.5% and were higher than children living in rural - There is an association between the mother's pregnancy RECEFENCES Nguyen The Manh The clinical features of children with attention deficit hyperactivity disorder Master Thesis in Medicine Hanoi Medical University 2009 Nguyen Thi Thu Hien Study on the rate of primary school children with attention deficit disorder in Badinh district, Hanoi Master Thesis in Psychology University Education Hanoi National University 2012 Pham H.D, Nguyen H.B, Tran D.T The prevalence of ADHD in primary school children in Vinh Long, Vietnam Pediatrint 2015, pp.10-15, 20 American Psychiatric Association Diagnostic and statistical manual of mental disorders, American Psychiatric Association Washington 1994, pp.78-85 Fleck K, Jacob V Child impact on family functioning: A multivariate analysis in multiplex Journal of military pharmaco-medicine n02-2019 families with children and mothers both affected by attention-deficit/hyperactivity disorder Atten Defic Hyperact Disord 2015, (3), pp.211-223 Lee S.Y, Wang L.J Prevalence rates of youths diagnosed with and medicated for ADHD in a nationwide survey in Taiwan from 2000 to 2011 Epidemiol Psychiatr Sci 2016, 20, pp.1-11 Mackie S, Shaw P Cerebellar development and clinical outcome in attention deficit hyperactivity disorder American Journal Psychiatry USA 2007, 163 (12), pp.647-2063 Yuki K, Bhagia J How does a real-world child psychiatric clinic diagnose and treat attention deficit hyperactivity disorder? World J Psychiatr Baishideng Publishing Group Inc 2016, (1), pp.118-127 Raynaud J.P, Garralda E.M Increasing awareness of child and adolescent mental health Jason Aronson, Inc 2010 10 Xiao Z.H, Wang Q.H Comorbidities and functional impairments in children with attention deficit hyperactivity disorder, Chin J Contemp Pediatr 2013, 15 (9), p.728-732 163 ... symptoms of attention deficit disorder: Table 5: Clinical features of attention deficit disorder n = 132 The expression of attention deficit disorder Mean SD Do not pay attention to the details/mistakes... rural - There is an association between the mother's pregnancy RECEFENCES Nguyen The Manh The clinical features of children with attention deficit hyperactivity disorder Master Thesis in Medicine... stimuli of attention deficit disorder was the highest (1.64) and next difficult to sustain attention in tasks/activities (1.58) - The symptoms of hyperactivity disorder: Table 6: Clinical features of