Prevalence of Attention Deficit Hyperactivity Disorder and Sluggish Cognitive Tempo Symptoms in Children Presenting with Foreign Body Ingestion: A Case-Control Study
Creators
- 1. Department of Pediatric Surgery, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye.
- 2. Department of Child and Adolescent Psychiatry, Ufuk University Faculty of Medicine, Ankara, Türkiye.
- 3. The Ministry of Health, Provincial Ambulance Service Command and Control Center, Kilis, Türkiye.
- 4. Division of Pediatric Gastroenterology, Department of Pediatrics, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye.
Description
Abstract
Foreign body ingestion (FBI) is one of the common causes of emergency admissions in infancy and childhood. Although the large majority of children who present with the FBI have no psychiatric diagnosis, present studies demonstrate that attention deficit hyperactivity disorder (ADHD) and related psychiatric problems might be a risk factor for FBI. This study aimed to compare the demographic variables and attention deficit hyperactivity disorder levels and sluggish cognitive tempo symptoms (ADHD-SCT) in children who ingested foreign bodies with healthy children. Also, we aimed to address the relationship between ADHD-SCT symptoms and the age of FBI. The FBI group comprised 44 children (age 2-8, median age: 5, 68.2% boys) admitted to the emergency, pediatric surgery, and pediatric gastroenterology department after FBI, and the healthy control group comprised 30 children (age 3-8, median age: 6, 56.7% boys). We administered the sociodemographic information form, SNAP-IV ADHD rating scale, and Barkley’s child SCT ratings scale to both groups of parents. Our results demonstrated that maternal education level was significantly lower in the FBI group, although other demographic characteristics of the samples were similar (p=0.023). In addition, ADHD-hyperactivity/impulsivity scores were significantly higher in the FBI group (p=0.01). Still, there were no significant differences in ADHD-inattention, SCT-daydreaming, and SCT-sluggishness scores (for all, p>0.05). We found positive-moderate relationships between SCT-daydreaming and sluggishness symptoms and FBI age (r=0.314, r=0.348, respectively). This means that higher SCT scores are related to an older FBI age. In conclusion, for the first time, we evaluated the ADHD and SCT symptoms in young children against FBI and found that ADHD-hyperactivity, but not ADHD-inattention symptoms, were significantly higher in the FBI group, and SCT symptoms increase the risk of FBI at an older age. In addition, we found that a lower maternal education level could be an additional risk factor for FBI. Despite the high hyperactivity in the FBI group, the low rate of child psychiatry evaluation should be considered when evaluating a child.
Özet
Yabancı cisim (YC) yutulması, bebeklik ve çocukluk döneminde acil başvuruların yaygın nedenlerinden biridir. YC yutma ile başvuran çocukların büyük çoğunluğunda psikiyatrik tanı olmamasına rağmen, mevcut çalışmalar gösteriyor ki, dikkat eksikliği hiperaktivite bozukluğu (DEHB) ve ilişkili psikiyatrik problemler YC yutma için bir risk faktörü olabilir. Bu çalışmada yabancı cisim yutan çocuklarda demografik değişkenler ile dikkat eksikliği hiperaktivite bozukluğu düzeyleri ve ağır bilişsel tempo semptomlarının (DEHB-SCT) sağlıklı çocuklarla karşılaştırılması amaçlandı. Aynı zamanda DEHB-SCT belirtileri ile YC yutma yaşı arasındaki ilişkiyi belirlemeyi amaçladık. YC yutma grubu, yabancı cisim yutma sonrası acil, çocuk cerrahisi ve pediatrik gastroenteroloji bölümüne başvuran 44 çocuktan (yaş 2-8, ortanca yaş: 5, %68.2 erkek) ve sağlıklı kontrol grubu 30 çocuktan (yaş 3-8, medyan yaş: 6, %56.7 erkek) oluşmaktadır. Her iki ebeveyn grubuna da sosyodemografik bilgi formu, SNAP-IV DEHB derecelendirme ölçeği ve Barkley's Child SCT derecelendirme ölçeğini uyguladık. Bulgularımız, örneklemlerin diğer demografik özellikleri benzer olmasına rağmen, anne eğitim düzeyinin YC yutma grubunda anlamlı olarak düşük (p=0.023) olduğunu gösterdi. Ayrıca YC yutma grubunda DEHB-hiperaktivite/dürtüsellik puanları anlamlı olarak yüksekti (p=0.01). Yine de, DEHB-dikkatsizlik, SCT-hayal kurma ve SCT-tembellik puanlarında anlamlı bir fark yoktu (tümü için, p>0.05). SCT-hayal kurma ve halsizlik semptomları ile YC yutma yaşı arasında pozitif-orta derecede ilişkiler bulduk (sırasıyla r=0.314, r=0.348). Bu, daha yüksek SCT puanlarının daha ileri YC yutma yaşıyla ilişkili olduğu anlamına gelir. Küçük çocuklarda ilk kez DEHB ve SCT belirtilerini YC yutan hastalarda değerlendirdik ve DEHB-dikkatsizlik belirtilerinin (DEHB-hiperaktivite belirtilerinin değil) YC yutma grubunda anlamlı olarak daha yüksek olduğunu ve daha büyük yaşlarda SCT belirtilerinin, YC yutma riskini artırdığını bulduk. Ayrıca anne eğitim seviyesinin düşük olmasının YC yutma için ek bir risk faktörü olabileceğini bulduk. YC yutma grubunda hiperaktivitenin yüksek olmasına rağmen, çocuk değerlendirilirken çocuk psikiyatrisi konsültasyon oranının düşük olması göz önünde bulundurulmalıdır.
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