Developmental Disorders and Functional Impairment as Predictors of Hospitalization in Preschoolers with ADHD

Objective

The present study was designed to characterize demographically and clinically a sample of preschool-aged children with ADHD, in order to explore factors that could be involved in determining the severity of their functional impairment.

Method

Medical records of children evaluated at our Preschoolers` Department during 2009-2012 were sistematically reviewed in order to identify children diagnosed as suffering from ADHD. The cohort included 111 children (5.13±0.55 years, 77.47% boys). They were assigned to be treated at the Day-care Intensive Unit (DCIU) or on an ambulatory basis, according to the severity of their functional impairment. Demographic and clinical variables of the two groups were statistically analyzed.

Results

Preschoolers in the DCIU were younger than their less impaired peers (p<.001), and were more frequently raised by divorced, separated or single parents (p<.001). The DCIU group was found to have higher rates of comorbidity. No difference was found between the groups in the number of inattentiove or hyperactivity-impulsivity clusters of DSM criteria. Developmental comorbidity, but not externalizing nor internalizing psychopathology, was significantly higher in the DCIU group (p<.001, p=.825, p=.198 respectively).

Conclusions

Preschoolers suffering from ADHD tend to show variable degrees of clinical severity an funcional impairment. In our sample, the clinical severity was related to younger age, parenthood characteristics and comorbidity. Interestingly, only comorbid Neurodevelopmental Disorders were found to be associated with the severity of the child`s functional impairment. These findings stress the importance of understanding and approaching ADHD in the context of the neurodevelopmental paradigm, especially at young age.