Informação do artigo
Abstract
Objective
Attention deficit/hyperactivity disorder (ADHD) is highly prevalent, and its symptoms often represent a significant public health problem; thus, the aim of this study was to verify emergency situations caused by certain comorbidities, or by exposing the patient to a higher risk of accidents.
Data sourceA literature search was carried out in the PubMed database between the years 1992 and 2012, using the key words “adhd”, “urgency”, “comorbidity”, “substance disorder”, “alcohol”, “eating disorder”, “suicide”, “trauma”, “abuse”, “crime”, “internet”, “videogame”, “bullying”, and their combinations. The selection considered the most relevant articles according to the scope of the proposed topic, performed in a non-systematic way.
Data synthesisSeveral situations were observed in which ADHD is the most relevant psychiatric diagnosis in relation to its urgency, such as the risk of accidents, suicide risk and addition, exposure to violence, or risk of internet abuse or sexual abuse; or when ADHD is the most prevalent comorbidity and is also correlated with emergency situations, such as in bipolar and eating disorders.
ConclusionsThe results show several comorbidities and risk situations involving the diagnosis of ADHD, thus reinforcing the importance of their identification for the adequate treatment of this disorder.
Keywords:
Attention deficit/ hyperactivity disorder
Urgency
Comorbidity
Resumo
Objetivo
O transtorno de déficit de atenção/hiperatividade (TDAH) apresenta alta prevalência, e seus sintomas apresentam-se frequentemente como um problema de saúde pública considerável. Assim, o objetivo desta revisão é verificar estas situações de urgência provocadas por determinadas comorbidades, ou por expor o paciente a um maior risco de acidentes.
Fonte dos dadosFoi realizada uma pesquisa bibliográfica na base de dados PubMed entre os anos de 1992 e 2012, utilizando os descritores “adhd”, “urgency”, “comorbidi- ty”, “substance disorder”, “alcohol”, “eating disorder”, “suicide”, “trauma”, “abuse”, “crime”, “internet”, “videogame”, “bullying”, e suas combinações. A seleção dos arti- gos considerou aqueles mais relevantes de acordo com a abrangência do tema proposto, de forma não sistemática.
Síntese dos dadosForam encontradas diversas situações em que o TDAH é o diagnóstico psiquiátrico mais relevante em relação à urgência, como risco de acidentes, risco de suicídio e adição, exposição à violência ou risco de abuso de internet ou abuso sexual; ou então o TDAH é a comorbidade mais prevalente e está igualmente correlacionada à urgência, como no transtorno de humor bipolar e nos transtornos alimentares.
ConclusõesNossos resultados mostram diversas comorbidades e situações de risco envol- vendo o diagnóstico de TDAH e, assim, reforçam a importância de serem reconhecidas para um tratamento adequado deste transtorno.
Palavras-chave:
Transtorno de déficit de atenção/ hiperatividade
Urgência
Comorbidade
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Referências
[1]
Psychiatry Association (APA). Diagnostic and Statistical Manual of Mental Diseases. 4th ed. Washington, DC: American Psychiatric Association; 1994.
[2]
World Health Organization (WHO). The ICD-10 Classification of Mental and Behavior Disorders. Geneva: WHO; 1992.
[3]
S.V. Faraone, J. Sergeant, C. Gillberg, J. Biederman.
The worldwide prevalence of ADHD: is it an American condition?.
World Psychiatry., 2 (2003), pp. 104-113
[4]
R.A. Barkley, A.D. Anastopoulos, D.C. Guevremont, K.E. Fletcher.
Adolescents with ADHD: patterns of behavioral adjustment, academic functioning, and treatment utilization.
J Am Acad Child Adolesc Psychiatry., 30 (1991), pp. 752-761
[5]
W.J. Barbaresi, S.K. Katusic, R.C. Colligan, A.L. Weaver, S.J. Jacobsen.
Long-term school outcomes for children with attention-deficit/hyperactivity disorder: a population-based perspective.
J Dev Behav Pediatr., 28 (2007), pp. 265-273
[6]
Conselho Federal de Medicina. Resolução n.° 1451/95, artigo 1°, parágrafo 1°. Publicada no D.O.U. de 17/03/1995, Seção I, p. 3666.
[7]
L. Culpepper.
Primary care treatment of attention-deficit/hyperactivity disorder.
J Clin Psychiatry., 67 (2006), pp. 51-58
[8]
A. Faber, L.J. Kalverdijk, L.T. de Jong-van den Berg, J.G. Hugtenburg, R.B. Minderaa, H. Tobi.
Parents report on stimulant-treated children in the Netherlands: initiation of treatment and follow- up care. J Child.
Adolesc Psychopharmacol, 16 (2006), pp. 432-440
[9]
American.
Academy of Pediatrics; American College of Emergency Physicians, Dolan MA.
Mace SE. Pediatric mental health emergencies in the emergency medical services system. American College of Emergency Physicians. Ann Emerg Med., 48 (2006), pp. 484-486
[10]
W.E. Pelham, E.M. Foster, J.A. Robb.
The economic impact of attention-deficit/hyperactivity disorder in children and adolescents.
J Pediatr Psychol., 32 (2007), pp. 711-727
[11]
American Academy of Pediatrics. Subcommittee on Attention-Deficit/Hyperactivity Disorder and Committee on Quality Improvement. Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity disorder. Pediatrics. 2001; 108:1033-44.
[12]
J. Biederman, J. Newcorn, S. Sprich.
Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders.
Am J Psychiatry., 148 (1991), pp. 564-577
[13]
T.W. Miller, J.T. Nigg, S.V. Faraone, Axis I.
and II comorbidity in adults with ADHD. J.
Abnorm Psychol, 116 (2007), pp. 519-528
[14]
G. Polanczyk, M.S. de Lima, B.L. Horta, J. Biederman, L.A. Rohde.
The worldwide prevalence of ADHD: a systematic review and metaregression analysis.
Am J Psychiatry., 164 (2007), pp. 942-948
[15]
T.E. Wilens, S.V. Faraone, J. Biederman.
Attention-deficit/hyperactivity disorder in adults.
JAMA., 292 (2004), pp. 619-623
[16]
L.A. Rohde, J. Biederman, E.A. Busnello, H. Zimmermann, M. Schmitz, S. Martins, et al.
ADHD in a school sample of Brazilian adolescents: a study of prevalence, comorbid conditions, and impairments.
J Am Acad Child Adolesc Psychiatry., 38 (1999), pp. 716-722
[17]
L. Anselmi, A.M. Menezes, F.C. Barros, P.C. Hallal, C.L. Araújo, M.R. Domingues, et al.
Early determinants of attention and hyperactivity problems in adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study.
Cad Saúde Pública., 26 (2010), pp. 1954-1962
[18]
D.P. Cantwell.
Attention deficit disorder: a review of the past 10 years.
J Am Acad Child Adolesc Psychiatry., 35 (1996), pp. 978-987
[19]
S.V. Faraone, J. Biederman, M.C. Monuteaux.
Attention-deficit disorder and conduct disorder in girls: evidence for a familial subtype.
Biol Psychiatry., 48 (2000), pp. 21-29
[20]
B.B. Lahey, B. Applegate, K. McBurnett, J. Biederman, L. Greenhill, G.W. Hynd, et al.
DSM-IV field trials for attention deficit hyperactivity disorder in children and adolescents.
Am J Psychiatry., 151 (1994), pp. 1673-1685
[21]
L.A. Rohde, C. Szobot, G. Polanczyk, M. Schmitz, S. Martins, S. Tramontina.
Attention-deficit/hyperactivity disorder in a diverse culture: do research and clinical findings support the notion of a cultural construct for the disorder?.
Biol Psychiatry., 57 (2005), pp. 1436-1441
[22]
M. Gaub, C.L. Carlson.
Behavioral characteristics of DSM-IV ADHD subtypes in a school-based population.
J Abnorm Child Psychol., 25 (1997), pp. 103-111
[23]
A. Baumgaertel, M.L. Wolraich, M. Dietrich.
Comparison of diagnostic criteria for attention deficit disorders in a German elementary school sample.
J Am Acad Child Adolesc Psychiatry., 34 (1995), pp. 629-638
[24]
M. Schmitz, L. Cadore, M. Paczko, L. Kipper, M. Chaves, L.A. Rohde, et al.
Neuropsychological performance in DSM-IV ADHD subtypes: an exploratory study with untreated adolescents.
Can J Psychiatry., 47 (2002), pp. 863-869
[25]
B. Hesslinger, T. Thiel, L. Tebartz van Elst, J. Hennig, D. Ebert.
Attention-deficit disorder in adults with or without hyperactivity: where is the difference?. A study in humans using short echo (1)H-magnetic resonance spectroscopy.
Neurosci Lett., 304 (2001), pp. 117-119
[26]
J.M. Swanson, M. Kinsbourne, J. Nigg, B. Lanphear, G.A. Stefanatos, N. Volkow, et al.
Etiologic subtypes of attention-deficit/hyperactivity disorder: brain imaging, molecular genetic and environmental factors and the dopamine hypothesis.
Neuropsychol Rev., 17 (2007), pp. 39-59
[27]
C.E. Paternite, J. Loney, M.A. Roberts.
External validation of oppositional disorder and attention deficit disorder with hyperactivity.
J Abnorm Child Psychol., 23 (1995), pp. 453-471
[28]
A.E. Morgan, G.W. Hynd, C.A. Riccio, J. Hall.
Validity of DSM-IV ADHD predominantly inattentive and combined types: relationship to previous DSM diagnoses/subtype differences.
J Am Acad Child Adolesc Psychiatry., 35 (1996), pp. 325-333
[29]
M.J. Sørensen, O. Mors, P.H. Thomsen.
DSM-IV or ICD-10-DCR diagnoses in child and adolescent psychiatry: does it matter?.
Eur Child Adolesc Psychiatry., 14 (2005), pp. 335-340
[30]
C. Ertan, Özcan ÖÖ, M.S. Pepele.
Paediatric trauma patients attention deficit hyperactivity disorder: correlation significance.
Emerg Med J., 29 (2012), pp. 911-914
[31]
C.L. Leibson, W.J. Barbaresi, J. Ransom, R.C. Colligan, J. Kemner, A.L. Weaver, et al.
Emergency department use and costs for youth with attention-deficit/hyperactivity disorder: associations with stimulant treatment.
Ambul Pediatr., 6 (2006), pp. 45-53
[32]
Y. Shilon, Y. Pollak, A. Aran, S. Shaked, V. Gross-Tsur.
Accidental injuries are more common in children with attention deficit hyperactivity disorder compared with their non-affected siblings.
Child Care Health Dev., 38 (2012), pp. 366-370
[33]
R.A. Barkley, D. Cox.
A review of driving risks and impairments associated with attention-deficit/hyperactivity disorder and the effects of stimulant medication on driving performance.
J Safety Res., 38 (2007), pp. 113-128
[34]
L. Jerome, L. Habinski, A. Segal.
Attention-deficit/hyperactivity disorder (ADHD) and driving risk: a review of the literature and a methodological critique.
Curr Psychiatry Rep., 8 (2006), pp. 416-426
[35]
M. Fischer, R.A. Barkley, L. Smallish, K. Fletcher.
Hyperactive children as young adults: driving abilities, safe driving behavior, and adverse driving outcomes.
Accid Anal Prev., 39 (2007), pp. 94-105
[36]
S.C. Lapham, J. C’de Baca, G.P. McMillan, J. Lapidus.
Psychiatric disorders in a sample of repeat impaired-driving offenders.
J Stud Alcohol., 67 (2006), pp. 707-713
[37]
O. Sabuncuoglu, H. Taser, M. Berkem.
Relationship between traumatic dental injuries and attention-deficit/hyperactivity disorder in children and adolescents: proposal of an explanatory model.
Dent Traumatol., 21 (2005), pp. 249-253
[38]
O. Sabuncuoglu.
Traumatic dental injuries and attention-deficit/hyperactivity disorder: is there a link?.
Dent Traumatol., 23 (2007), pp. 137-142
[39]
S. Thikkurissy, D.J. McTigue, D.L. Coury.
Children presenting with dental trauma are more hyperactive than controls as measured by the ADHD rating scale IV.
Pediatr Dent., 34 (2012), pp. 28-31
[40]
Daviss WB, Diler RS. Suicidal behaviors in adolescents with ADHD: associations with depressive and other comorbidity, parent-child conflict, trauma exposure, and impairment. J Atten Disord. 2012 Jul 19. http://dx.doi.org/10.1177/1087054712451127.
[41]
A. James, F.H. Lai, C. Dahl.
Attention deficit hyperactivity disorder and suicide: a review of possible associations.
Acta Psychiatr Scand., 110 (2004), pp. 408-415
[42]
I. Manor, I. Gutnik, D.H. Ben-Dor, A. Apter, J. Sever, S. Tyano, et al.
Possible association between attention deficit hyperactivity disorder and attempted suicide in adolescents – a pilot study.
Eur Psychiatry., 25 (2010), pp. 146-150
[43]
T.M. Kelly, J.R. Cornelius, D.B. Clark.
Psychiatric disorders and attempted suicide among adolescents with substance use disorders.
Drug Alcohol Depend., 73 (2004), pp. 87-97
[44]
K.M. Carroll, B.J. Rounsaville.
History and significance of childhood attention deficit disorder in treatment-seeking cocaine abusers.
Compr Psychiatry., 34 (1993), pp. 75-82
[45]
H. Schubiner, A. Tzelepis, S. Milberger, N. Lockhart, M. Kruger, B.J. Kelley, et al.
Prevalence of attention-deficit/hyperactivity disorder and conduct disorder among substance abusers.
J Clin Psychiatry., 61 (2000), pp. 244-251
[46]
J. Biederman, C.R. Petty, C. Dolan, S. Hughes, E. Mick, M.C. Monuteaux, et al.
The long-term longitudinal course of oppositional defiant disorder and conduct disorder in ADHD boys: findings from a controlled 10-year prospective longitudinal follow-up study.
Psychol Med., 38 (2008), pp. 1027-1036
[47]
C.M. Szobot, L.A. Rohde, O. Bukstein, B.S. Molina, C. Martins, P. Ruaro, et al.
Is attention-deficit/hyperactivity disorder associated with illicit substance use disorders in male adolescents?. A community-based case-control study.
Addiction., 102 (2007), pp. 1122-1130
[48]
M.K. Singh, M.P. DelBello, R.A. Kowatch, S.M. Strakowski.
Co- occurrence of bipolar and attention-deficit hyperactivity disorders in children.
Bipolar Disord., 8 (2006), pp. 710-720
[49]
R. Donfrancesco, S. Miano, F. Martines, L. Ferrante, M.G. Melegari, G. Masi.
Bipolar disorder co-morbidity in children with attention deficit hyperactivity disorder.
Psychiatry Res., 186 (2011), pp. 333-337
[50]
A.P. Wingo, S.N. Ghaemi.
Frequency of stimulant treatment and of stimulant-associated mania/hypomania in bipolar disorder patients.
Psychopharmacol Bull., 41 (2008), pp. 37-47
[51]
K. Holmberg, A. Hjern.
Bullying and attention-deficit- hyperactivity disorder in 10-year-olds in a Swedish community.
Dev Med Child Neurol., 50 (2008), pp. 134-138
[52]
G. Montes, J.S. Halterman.
Bullying among children with autism and the influence of comorbidity with ADHD: a population- based study.
Ambul Pediatr., 7 (2007), pp. 253-257
[53]
C. Vreugdenhil, T.A. Doreleijers, R. Vermeiren, L.F. Wouters, W. van den Brink.
Psychiatric disorders in a representative sample of incarcerated boys in the Netherlands.
J Am Acad Child Adolesc Psychiatry., 43 (2004), pp. 97-104
[54]
Reinhardt M, Pheula G, Karam R, Zingano B, Falceto O. Prevalência de diagnósticos psiquiátricos em adolescentes infratores no centro de internação provisória de Porto Alegre- RS. Trabalho apresentado no XIX Congresso da ABENEPI. 2007.[não publicado].
[55]
J.H. Satterfield, K.J. Faller, F.M. Crinella, A.M. Schell, J.M. Swanson, L.D. Homer.
A 30-year prospective follow-up study of hyperactive boys with conduct problems: adult criminality.
J Am Acad Child Adolesc Psychiatry., 46 (2007), pp. 601-610
[56]
J.H. Ha, H.J. Yoo, I.H. Cho, B. Chin, D. Shin, J.H. Kim.
Psychiatric comorbidity assessed in Korean children and adolescents who screen positive for Internet addiction.
J Clin Psychiatry., 67 (2006), pp. 821-826
[57]
J.Y. Yen, C.H. Ko, C.F. Yen, H.Y. Wu, M.J. Yang.
The comorbid psychiatric symptoms of Internet addiction: attention deficit and hyperactivity disorder (ADHD), depression, social phobia, and hostility.
J Adolesc Health., 41 (2007), pp. 93-98
[58]
F. Cao, L. Su, T. Liu, X. Gao.
The relationship between impulsivity and Internet addiction in a sample of Chinese adolescents.
Eur Psychiatry., 22 (2007), pp. 466-471
[59]
P.A. Chan, T. Rabinowitz.
A cross-sectional analysis of video games and attention deficit hyperactivity disorder symptoms in adolescents.
Ann Gen Psychiatry., 5 (2006), pp. 16
[60]
H.J. Yoo, S.C. Cho, J. Ha, S.K. Yune, S.J. Kim, J. Hwang, et al.
Attention deficit hyperactivity symptoms and internet addiction.
Psychiatry Clin Neurosci., 58 (2004), pp. 487-494
[61]
E. Cengel-Kültür, F. Cuhadaroğlu-Cetin, B. Gökler.
Demographic and clinical features of child abuse and neglect cases.
Turk J Pediatr., 49 (2007), pp. 256-262
[62]
A.M. Briscoe-Smith, S.P. Hinshaw.
Linkages between child abuse and attention-deficit/hyperactivity disorder in girls: behavioral and social correlates.
Child Abuse Negl., 30 (2006), pp. 1239-1255
[63]
J.J. Rucklidge, D.L. Brown, S. Crawford, B.J. Kaplan.
Retrospective reports of childhood trauma in adults with ADHD.
J Atten Disord., 9 (2006), pp. 631-641
[64]
L. Sugaya, D.S. Hasin, M. Olfson, K.H. Lin, B.F. Grant, C. Blanco.
Child physical abuse and adult mental health: a national study.
J Trauma Stress., 25 (2012), pp. 384-392
[65]
P. Mattos, E. Saboya, V. Ayrão, D. Segenreich, M. Duchesne, G. Coutinho.
Comorbid eating disorders in a Brazilian attention-deficit/hyperactivity disorder adult clinical sample.
Rev Bras Psiquiatr., 26 (2004), pp. 248-250
[66]
J. Biederman, S.W. Ball, M.C. Monuteaux, C.B. Surman, J.L. Johnson, S. Zeitlin.
Are girls with ADHD at risk for eating disorders? Results from a controlled, five-year prospective study.
J Dev Behav Pediatr., 28 (2007), pp. 302-307
[67]
L.K. Leslie, J. Weckerly, D. Plemmons, J. Landsverk, S. Eastman.
Implementing the American Academy of Pediatrics attention- deficit/hyperactivity disorder diagnostic guidelines in primary care settings.
Pediatrics., 114 (2004), pp. 129-140
[68]
H. Abikoff, L.E. Arnold, J.H. Newcorn, G.R. Elliott, L. Hechtman, J.B. Severe, et al.
Emergency/Adjunct services and attrition prevention for randomized clinical trials in children: the MTA manual-based solution.
J Am Acad Child Adolesc Psychiatry., 41 (2002), pp. 498-504
[69]
A. Thapar, A. Thapar.
Is primary care ready to take on Attention Deficit Hyperactivity Disorder?.
BMC Fam Pract., 3 (2002), pp. 7
[70]
L.A. Rohde, R. Halpern.
Transtorno de déficit de atenção/hiperatividade: atualização.
J Pediatr (Rio J)., 80 (2004), pp. S61-S70
[71]
F. López Seco, A. Masana Marín, S. Martí Serrano, S. Acosta García, A.M. Gaviria Gómez.
The course of attention deficit/hyperactivity disorder in an outpatient sample.
An Pediatr (Barc)., 76 (2012), pp. 250-255
Como citar este artigo: Reinhardt MC, Reinhardt CA. Attention deficit-hyperactivity disorder, comorbidities, and risk situations. J Pediatr (Rio J). 2013;89:124−30.
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