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Child and Adolescent Psychiatry and Mental Health
Published in: Child and Adolescent Psychiatry and Mental Health 1/2012

Open Access 01-12-2012 | Research

Social and emotional difficulties in children with ADHD and the impact on school attendance and healthcare utilization

Authors: Peter Classi, Denái Milton, Sarah Ward, Khaled Sarsour, Joseph Johnston

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2012

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Abstract

Background

The objective of this study was to examine the impact of co-occurring social and emotional difficulties on missed school days and healthcare utilization among children with attention deficit/hyperactivity disorder (ADHD).

Methods

Data were from the 2007 U.S. National Health Interview Survey (NHIS) and were based on parental proxy responses to questions in the Sample Child Core, which includes questions on demographics, health, healthcare treatment, and social and emotional status as measured by questions about depression, anxiety, and phobias, as well as items from the brief version of the Strength and Difficulties Questionnaire (SDQ). Logistic regression was used to assess the association between co-occurring social and emotional difficulties with missed school days and healthcare utilization, adjusting for demographics.

Results

Of the 5896 children aged 6–17 years in the 2007 NHIS, 432 (7.3%) had ADHD, based on parental report. Children with ADHD and comorbid depression, anxiety, or phobias had significantly greater odds of experiencing > 2 weeks of missed school days, ≥ 6 visits to a healthcare provider (HCP), and ≥ 2 visits to the ER, compared with ADHD children without those comorbidities (OR range: 2.1 to 10.4). Significantly greater odds of missed school days, HCP visits, and ER visits were also experienced by children with ADHD who were worried, unhappy/depressed, or having emotional difficulties as assessed by the SDQ, compared with ADHD children without those difficulties (OR range: 2.2 to 4.4).

Conclusions

In children with ADHD, the presence of social and emotional problems resulted in greater odds of missed school days and healthcare utilization. These findings should be viewed in light of the limited nature of the parent-report measures used to assess social and emotional problems.
Literature
1.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 2000, Washington, DC: American Psychiatric Association, 4
2.
Rowland AS, Lesesne CA, Abramowitz AJ: The epidemiology of attention-deficit/hyperactivity disorder (ADHD): a public health view. Ment Retard Dev Disabil Res Rev. 2002, 8: 162-170. 10.1002/mrdd.10036.CrossRefPubMed
3.
Pastor PN, Reuben CA, Loeb M: Functional difficulties among school-aged children: United States, 2001–2007. National health statistics reports no. 19. 2009, Hyattsville, MD: National Center for Health Statistics
4.
5.
Bloom B, Cohen RA, Freeman G: Summary health statistics for U.S. children: National Health Interview Survey, 2007. Vital Health Stat. 2009, 239 (10): 1-80.
6.
Strine TW, Lesesne CA, Okoro CA, McGuire LC, Chapman DP, Balluz LS, Mokdad AH: Emotional and behavioral difficulties and impairments in everyday functioning among children with a history of attention-deficit/hyperactivity disorder. Prev Chronic Dis. 2006, 3: A52.PubMedCentralPubMed
7.
Wehmeier PM, Schacht A, Barkley RA: Social and emotional impairment in children and adolescents with ADHD and the impact on quality of life. J Adolesc Health. 2010, 46: 209-217. 10.1016/j.jadohealth.2009.09.009.CrossRefPubMed
8.
Loe IM, Feldman HM: Academic and educational outcomes of children with ADHD. J Pediatr Psychol. 2007, 32: 643-654. 10.1093/jpepsy/jsl054.CrossRefPubMed
9.
Galera C, Melchior M, Chastang JF, Bouvard MP, Fombonne E: Childhood and adolescent hyperactivity-inattention symptoms and academic achievement 8 years later: the GAZEL Youth study. Psychol Med. 2009, 39: 1895-1906. 10.1017/S0033291709005510.PubMedCentralCrossRefPubMed
10.
Guevara J, Lozano P, Wickizer T, Mell L, Gephart H: Utilization and cost of health care services for children with attention-deficit/hyperactivity disorder. Pediatrics. 2001, 108: 71-78. 10.1542/peds.108.1.71.CrossRefPubMed
11.
Chan E, Zhan C, Homer CJ: Health care use and costs for children with attention-deficit/hyperactivity disorder: national estimates from the medical expenditure panel survey. Arch Pediatr Adolesc Med. 2002, 156: 504-511.CrossRefPubMed
12.
Leibson CL, Katusic SK, Barbaresi WJ, Ransom J, O'Brien PC: Use and costs of medical care for children and adolescents with and without attention-deficit/hyperactivity disorder. JAMA. 2001, 285: 60-66. 10.1001/jama.285.1.60.CrossRefPubMed
13.
Marks DJ, Mlodnicka A, Bernstein M, Chacko A, Rose S, Halperin JM: Profiles of service utilization and the resultant economic impact in preschoolers with attention deficit/hyperactivity disorder. J Pediatr Psychol. 2009, 34: 681-689. 10.1093/jpepsy/jsn112.PubMedCentralCrossRefPubMed
14.
Szatmari P, Offord DR, Boyle MH: Correlates, associated impairments and patterns of service utilization of children with attention deficit disorder: findings from the Ontario Child Health Study. J Child Psychol Psychiatry. 1989, 30: 205-217. 10.1111/j.1469-7610.1989.tb00235.x.CrossRefPubMed
15.
Cuffe SP, Moore CG, McKeown R: ADHD and health services utilization in the national health interview survey. J Atten Disord. 2009, 12: 330-340.CrossRefPubMed
16.
17.
Meyers J, Classi P, Wietecha L, Candrilli S: Economic burden and comorbidities of attention-deficit/hyperactivity disorder among pediatric patients hospitalized in the United States. Child Adolesc Psychiatry Ment Health. 2010, 4: 31-10.1186/1753-2000-4-31.PubMedCentralCrossRefPubMed
18.
Klimkeit E, Graham C, Lee P, Morling M, Russo D, Tonge B: Children should be seen and heard: self-report of feelings and behaviors in primary-school-age children with ADHD. J Atten Disord. 2006, 10: 181-191. 10.1177/1087054706289926.CrossRefPubMed
19.
Schreyer I, Hampel P: ADHD among boys in childhood: quality of life and parenting behavior [in German]. Z Kinder Jugendpsychiatr Psychother. 2009, 37: 69-75. 10.1024/1422-4917.37.1.69.CrossRefPubMed
20.
Greene RW, Biederman J, Faraone SV, Monuteaux MC, Mick E, DuPre EP, Fine CS, Goring JC: Social impairment in girls with ADHD: patterns, gender comparisons, and correlates. J Am Acad Child Adolesc Psychiatry. 2001, 40: 704-710. 10.1097/00004583-200106000-00016.CrossRefPubMed
21.
McQuade JD, Hoza B: Peer problems in Attention Deficit Hyperactivity Disorder: current status and future directions. Dev Disabil Res Rev. 2008, 14: 320-324. 10.1002/ddrr.35.CrossRefPubMed
22.
Barkley RA: Attention-deficit/hyperactivity disorder: a handbook for diagnosis and treatment. 2006, New York: Guilford Press, 3
23.
Anastopoulos AD, Smith TF, Garrett ME, Morrissey-Kane E, Schatz NK, Sommer JL, Kollins SH, Ashley-Koch A: Self-regulation of emotion, functional impairment, and comorbidity among children with ADHD. J Atten Disord. 2011, 15: 583-592. 10.1177/1087054710370567.PubMedCentralCrossRefPubMed
24.
Bird HR, Gould MS, Staghezza BM: Patterns of diagnostic comorbidity in a community sample of children aged 9 through 16 years. J Am Acad Child Adolesc Psychiatry. 1993, 32: 361-368. 10.1097/00004583-199303000-00018.CrossRefPubMed
25.
Angold A, Costello EJ, Erkanli A: Comorbidity. J Child Psychol Psychiatry. 1999, 40: 57-87. 10.1111/1469-7610.00424.CrossRefPubMed
26.
Gillberg C, Gillberg IC, Rasmussen P, et al: Coexisting disorders in ADHD: implications for diagnosis and intervention. Eur Child Adolesc Psychiatry. 2004, 13 (Suppl 1): 180-192.
27.
Elia J, Ambrosini P, Berrettini W: ADHD characteristics: I. Concurrent comorbidity patterns in children and adolescents. Child Adolesc Psychiatry Ment Health. 2008, 2: 15-10.1186/1753-2000-2-15.PubMedCentralCrossRefPubMed
28.
The MTA Cooperative Group: A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 1999, 56: 1073-1086. 10.1001/archpsyc.56.12.1073.CrossRef
29.
Larson K, Russ SA, Kahn RS, Halfon N: Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007. Pediatrics. 2011, 127: 462-470. 10.1542/peds.2010-0165.PubMedCentralCrossRefPubMed
30.
Bowen R, Chavira DA, Bailey K, Stein MT, Stein MB: Nature of anxiety comorbid with attention deficit hyperactivity disorder in children from a pediatric primary care setting. Psychiatry Res. 2008, 157: 201-209. 10.1016/j.psychres.2004.12.015.CrossRefPubMed
31.
Hurtig T, Ebeling H, Taanila A, Miettunen J, Smalley S, McGough J, Loo S, Järvelin MR, Moilanen I: ADHD and comorbid disorders in relation to family environment and symptom severity. Eur Child Adolesc Psychiatry. 2007, 16: 362-369. 10.1007/s00787-007-0607-2.CrossRefPubMed
32.
Spencer TJ: Issues in the management of patients with complex attention-deficit hyperactivity disorder symptoms. CNS Drugs. 2009, 23 (Suppl 1): 9-20.CrossRefPubMed
33.
Daviss WB: A review of comorbid depression in pediatric ADHD: etiology, phenomenology, and treatment. J Child Adolesc Psychopharmacol. 2008, 18: 565-571. 10.1089/cap.2008.032.PubMedCentralCrossRefPubMed
34.
35.
Bloom B, Cohen RA: Summary health statistics for U.S. children: National Health Interview Survey, 2006. Vital Health Stat. 2007, 234 (10): 1-79.
36.
37.
38.
Goodman R: The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997, 38: 581-586. 10.1111/j.1469-7610.1997.tb01545.x.CrossRefPubMed
39.
SDQ: The Strengths and Difficulties Questionnaires. Information for researchers and professionals about the Strengths & Difficulties Questionnaires.http://​www.​sdqinfo.​org.
40.
Goodman R: Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001, 40: 1337-1345. 10.1097/00004583-200111000-00015.CrossRefPubMed
41.
Blackman GL, Ostrander R, Herman KC: Children with ADHD and depression: a multisource, multimethod assessment of clinical, social, and academic functioning. J Atten Disord. 2005, 8: 195-207. 10.1177/1087054705278777.CrossRefPubMed
42.
Mrug S, Hoza B, Gerdes AC: Children with attention-deficit/hyperactivity disorder: peer relationships and peer-oriented interventions. New Dir Child Adolesc Dev. 2001, 91: 51-77.CrossRefPubMed
43.
Kessler RC, Gruber M, Sampson N: Final report CDC contract 200-2003-01054: Validation studies of mental health indices in the National Health Interview Survey (with addendum). 2006
44.
Pastor PN, Reuben CA, Duran CR: Identifying emotional and behavioral problems in children aged 4–17 years: United States, 2001–2007. National health statisitcs reports; no 48. 2012, Hyattsville, MD: National Center for Health Statistics
45.
Goodman R, Ford T, Simmons H, Gatward R, Meltzer H: Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. Int Rev Psychiatry. 2003, 15 (1–2): 166-172.CrossRefPubMed
Metadata
Title
Social and emotional difficulties in children with ADHD and the impact on school attendance and healthcare utilization
Authors
Peter Classi
Denái Milton
Sarah Ward
Khaled Sarsour
Joseph Johnston
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2012
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/1753-2000-6-33

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