ADHD and gender: Are risks and sequela of ADHD the same for boys and girls

Background: Research comparing treatment-referred boys and girls with attention-deficit/hyperactivity disorder (ADHD) has yielded equivocal results. Contradictory findings may be associated with differential referral practices or unexplored interactions of gender with ADHD subtypes. Method: We examined possible gender differences in ADHD and its subtypes among children aged 4 to 17 in a representative community sample (N ¼ 1896) in Puerto Rico. Caretakers provided information through the Diagnostic Interview Schedule for Children (version IV) and a battery of impairment, family relations, child problems, comorbidity and treatment measures. Results: ADHD was 2.3 times more common in boys than girls, but with one exception there was little evidence that the patterns of associations of ADHD with correlates were different for boys and girls. The exception was school suspension, which was more common among ADHD boys than girls. Additional gender interactions were found when ADHD subtypes were considered. Among those with combined type (n ¼ 50), boys were more likely to be comorbid with mood disorders than girls. For those with the inattentive type (n ¼ 47), girls were more likely to be comorbid with anxiety disorders than boys. Conclusions: Our findings lend cross-cultural generalizability to recent reports that gender does not interact with correlates for ADHD overall, but that it may play a role in subtypes

Current Rates And Symptom Profiles Of Panic Disorder In Six Cross-national Studies:

One-month and 6-month prevalence and symptom profiles of panic disorder from six cross-national epidemiologic studies are reported. These studies were conducted at five sites in the United States, Puerto Rico, Germany, Lebanon, Korea, and New Zealand. Results show that the 1 - and 6-month rates were consistent in the five sites in the United States and in other countries. There was a predominance of females in the rates of panic disorder in most countries. Palpitations and trembling were prevalent in 60% or more persons with panic disorder at all sites. The results show that panic disorder is present with similar phenomenology in diverse cultures that have been studied

Epidemiological Comparisons of Puerto Rican and U.S. Mainland Children: Parent, Teacher, and Self-Reports

U.S. mainland and Puerto Rican nonreferred samples were compared via the Child Behavior Checklist (ages 4 to 16), Teacher\u27s Report Form (ages 6 to 16), and Youth Self-Report (ages 12 to 16). Problem scores were significantly higher in parent and teacher ratings of Puerto Rican than mainland subjects, but were significantly lower in self-ratings by Puerto Rican adolescents. Adolescents in both cultures reported significantly more problems than their parents or teachers did. Most of the significant cross-cultural differences in parent, teacher, and self-ratings of competencies showed more favorable scores for the mainland subjects. High referral rates, a high prevalence of DSM diagnoses, and low scores on the Children\u27s Global Assessment Scale are consistent with the high problem rates reported by Puerto Rican parents and teachers but not with the lower rates reported by adolescents. Different clinical cutoffs may be needed for all assessments in the mainland versus Puerto Rico

The alcohol, smoking and substance involvement screening test (ASSIST): development, reliability and feasibility

WHO ASSIST Working Group member: Robert Ali for Drug and Alcohol Addiction Services Council, Adelaide, AustraliaAIMS The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed for the World Health Organization (WHO) by an international group of substance abuse researchers to detect psychoactive substance use and related problems in primary care patients. This report describes the new instrument as well as a study of its reliability and feasibility. SETTING The study was conducted at participating sites in Australia, Brazil, Ireland, India, Israel, the Palestinian Territories, Puerto Rico, the United Kingdom and Zimbabwe. Sixty per cent of the sample was recruited from alcohol and drug abuse treatment facilities; the remainder was drawn from general medical settings and psychiatric facilities. METHODS The study was concerned primarily with test item reliability, using a simple test–retest procedure to determine whether subjects would respond consistently to the same items when presented in an interview format on two different occasions. Qualitative and quantitative data were also collected to evaluate the feasibility of the screening items and rating format. PARTICIPANTS A total of 236 volunteer participants completed test and retest interviews at nine collaborating sites. Slightly over half of the sample (53.6%) was male. The mean age of the sample was 34 years and they had completed, on average, 10 years of education. RESULTS The average test–retest reliability coefficients (kappas) ranged from a high of 0.90 (consistency of reporting ‘ever’ use of substance) to a low of 0.58 (regretted what was done under influence of substance). The average kappas for substance classes ranged from 0.61 for sedatives to 0.78 for opioids. In general, the reliabilities were in the range of good to excellent, with the following items demonstrating the highest kappas across all drug classes: use in the last 3 months, preoccupied with drug use, concern expressed by others, troubled by problems related to drug use, intravenous drug use. Qualitative data collected at the end of the retest interview suggested that the questions were not difficult to answer and were consistent with patients’ expectations for a health interview. The data were used to guide the selection of a smaller set of items that can serve as the basis for more extensive validation research. CONCLUSION The ASSIST items are reliable and feasible to use as part of an international screening test. Further evaluation of the screening test should be conducted