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01-12-2007 | ORIGINAL CONTRIBUTION

Predictors of diagnostic delay in a clinical sample of French children with attention-deficit/hyperactivity disorder

Authors: D. Purper-Ouakil, MD, PhD, S. Cortese, MD, M. Wohl, MD, M. Asch, MD, E. Acquaviva, MD, B. Falissard, G. Michel, PhD, P. Gorwood, MD, PhD, M. C. Mouren, MD

Published in: European Child & Adolescent Psychiatry | Issue 8/2007

Abstract

Background Early recognition of attention-deficit/hyperactivity disorder (ADHD) may improve the educational and psychosocial outcome of most affected children. To date, factors associated with diagnostic delay of ADHD have not specifically been addressed. Aims of this study were to evaluate the mean diagnostic delay (time between first consultation and definite diagnosis) in a clinical sample of French children with ADHD referred to an outpatient university clinic, and to determine associated factors. Method A total of 129 consecutively referred ADHD patients aged 6–16 years. A detailed history of the children was obtained from their parents. The Kiddie-SADS-PL, the ADHD-Rating Scale, and the Clinical Global Impression Scale were used for clinical assessment. Results Mean diagnostic delay was 32.89 months. A previous suspicion of ADHD by any health care professional, therapist or teacher was significantly associated with a reduced diagnostic delay. Co-morbidity with anxiety/depressive disorders and previous contact with a mental health professional were associated with a significant delay in diagnosis. Conclusion Delay in diagnosis of ADHD in France is among the longest reported. Children with co-morbid anxiety or depressive disorders are particularly at risk of having a significant delay in the diagnosis. Health professionals, therapists and teachers may play a relevant role to accelerate the diagnostic procedure.

American Academy of Pediatrics (2000) Clinical practice guideline: diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics 105:1158–1170CrossRef

Biederman J (2005) Attention-deficit/hyperactivity disorder: a selective overview. Biol Psychiatr 57:1215–1220CrossRef

Biederman J, Faraone SV, Spencer T, Wilens T, Norman D, Lapey KA, Mick E, Lehman BK, Doyle A (1993) Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am J Psychiatry 150:1792–1798PubMed

Biederman J, Kwon A, Aleardi M, Chouinard VA, Marino T, Cole H, Mick E, Faraone SV (2005) Absence of gender effects on attention deficit hyperactivity disorder: findings in nonreferred subjects. Am J Psychiatry 162:1083–1089PubMedCrossRef

Buitelaar JK (2002) Epidemiological aspects: what have we learned over the last decade? In: Sanberg S (ed) Hyperactivity and attention disorder of childhood. Cambridge University Press ed., Cambridge

Buitelaar JK, Rothenberger A (2004) Foreword—ADHD in the scientific and political context. Eur Child Adolesc Psychiatry 13(Suppl 1):I1–I6PubMed

Cantwell DP (1996) Attention deficit disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 35:978–987PubMedCrossRef

DuPaul GJ, Power TJ, Anastopoulos AD, Reid R (1998) ADHD Rating Scale-IV: checklists, norms, and clinical interpretation. Guilford Press, New York, NY

Faraone SV (2005) The scientific foundation for understanding attention-deficit/hyperactivity disorder as a valid psychiatric disorder. Eur Child Adolesc Psychiatry 14:1–10PubMedCrossRef

10.

INSEE classification (2005) Available at http://www.insee.fr/en/nom_def_met/nomenclatures/pcs.htm

11.

Jensen PS, Kettle L, Roper MT, Sloan MT, Dulcan MK, Hoven C, Bird HR, Bauermeister JJ Payne JD (1999) Are stimulants overprescribed? Treatment of ADHD in four U.S. communities. J Am Acad Child Adolesc Psychiatry 38:797–804PubMedCrossRef

12.

Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N (1997) Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–988PubMedCrossRef

13.

Klasen H, Goodman R (2000) Parents and GPs at cross-purposes over hyperactivity: a qualitative study of possible barriers to treatment. Br J Gen Practitioner 50:199–202

14.

LeFever GB, Dawson KV, Morrow AL (1999) The extent of drug therapy for attention deficit-hyperactivity disorder among children in public schools. Am J Public Health 89:1359–1364PubMedCrossRef

15.

Marcelli D (1999) Enfance et psychopathologie. Masson, Paris

16.

Mouren-Siméoni MC, Cook S, Flament M, Nedey-Saiag MC, Nollet-Clémençon C, Paillère-Martinot ML, Purper-Ouakil D,Vila G Kiddie-SADS-version vie entière (K-SADS-P/L) (2002) Edition revisée et modifiée. Editions INSERM

17.

Ralston SJ, Lorenzo MJ (2004) ADORE—Attention-Deficit Hyperactivity Disorder Observational Research in Europe. Eur Child Adolesc Psychiatry 13(Suppl 1):I36–I42PubMed

18.

Rappley MD (2005) Clinical practice. Attention deficit-hyperactivity disorder. N Engl J Med 352:165–173PubMedCrossRef

19.

Shekim WO, Asarnow RF, Hess E, Zaucha K, Wheeler N (1990) A clinical and demographic profile of a sample of adults with attention deficit hyperactivity disorder, residual state. Compr Psychiatry 31:416–425PubMedCrossRef

20.

Steinhausen HC, Metzke CW, Meier M, Kannenberg R (1998) Prevalence of child and adolescent psychiatric disorders: the Zurich Epidemiological Study. Acta Psychiatrica Scandinavica 98:262–271PubMedCrossRef

21.

Swanson JM, Sergeant JA, Taylor E, Sonuga-Barke EJ, Jensen PS, Cantwell DP (1998) Attention-deficit hyperactivity disorder and hyperkinetic disorder. Lancet 351:429–433PubMedCrossRef

22.

Taylor E, Sandberg S, Thorley G, Giles S (1991) The epidemiology of childhood hyperactivity. (Maudsley Monographs ed) (vols 33) London

23.

Taylor E, Dopfner M, Sergeant J, Asherson P, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Rothenberger A, Sonuga-Barke E, Steinhausen HC, Zuddas A (2004) European clinical guidelines for hyperkinetic disorder—first upgrade. Eur Child Adolesc Psychiatry 13(Suppl 1):I7–30PubMed

24.

Vila G, Zipper E, Dabbas M, Bertrand C, Robert JJ, Ricour C, Mouren Siméoni MC (2004) Mental disorders in obese children and adolescents. Psychosom Med 66:387–394PubMedCrossRef

25.

Wilens TE (1998) AOD use and attention deficit/hyperactivity disorder. Alcohol Health Res World 22:127–130PubMed

26.

Wolraich ML, Hannah JN, Pinnock TY, Baumgaertel A, Brown J (1996) Comparison of diagnostic criteria for attention-deficit hyperactivity disorder in a county-wide sample. Eur Child Adolesc Psychiatry 35:319–324CrossRef

27.

World Federation for Mental Health. ADHD impacts entire family: parents urge for faster diagnosis (2004). IACAPAP 16th World Congress, Berlin (data available at http://www.wfmh.org/publications/without_boundaries.htm)

28.

Zhang S, Faries DE, Volwes M, Michelson D (2005) ADHD rating scale IV: psychometric properties from a multinational study as a clinician-administered instrument. Int J Methods Psychiatr Res 14:186–201PubMedCrossRef

Title: Predictors of diagnostic delay in a clinical sample of French children with attention-deficit/hyperactivity disorder
Authors: D. Purper-Ouakil, MD, PhD
S. Cortese, MD
M. Wohl, MD
M. Asch, MD
E. Acquaviva, MD
B. Falissard
G. Michel, PhD
P. Gorwood, MD, PhD
M. C. Mouren, MD
Publication date: 01-12-2007
Publisher: D. Steinkopff-Verlag
Published in: European Child & Adolescent Psychiatry / Issue 8/2007
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI: https://doi.org/10.1007/s00787-007-0627-y

At a glance: The STEP trials

Springer Medicine

Predictors of diagnostic delay in a clinical sample of French children with attention-deficit/hyperactivity disorder

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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