It is well-known that more than 50% of attention-deficit hyperactivity disorder (ADHD) cases also have comorbid psychiatric disorders. We evaluated the comorbid psychopathology of Korean children and adolescents with ADHD using a standardized diagnostic instrument. The Korean Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL-K) was administered and completed in 105 patients who had been referred to the outpatient and inpatient clinics at the Samsung Medical Center from March 2004 to May 2005. All of the cases were diagnosed as ADHD according to DSM-IV criteria. We analyzed their clinical characteristics and psychiatric comorbidities, and assessed the correlation of any comorbidity with gender, age and ADHD subtype. Among our 105 participants, 70 (66.7%) subjects were diagnosed with combined-type ADHD, 22 (21.0%) were the predominantly inattentive type, only 1 (1.0%) was determined to have the predominantly hyperactive-impulsive type of ADHD, and 12 (11.4%) were classified as not otherwise specified (NOS) ADHD. Eighty (76.2%) subjects had at least one comorbid disorder such as oppositional defiant disorder (n = 53, 50.5%), anxiety disorders (n = 35, 33.3%) and affective disorders (n = 15, 14.3%). Our patients ranged in age from five to 16 years. Among the factors including gender, age, and ADHD subtype, ADHD subtype was the only one significant to comorbidity in our study. The results of this study suggest that psychiatric comorbidity in Korean children with ADHD is similar to the results of previous studies in western countries. Out of all the ADHD subtypes, the combined-type group had a significantly higher ratio of comorbid disorders and psychopathologies.
Tic Disorders/epidemiology ; Mood Disorders/epidemiology ; Mental Disorders/*epidemiology ; Male ; Korea/epidemiology ; Humans ; Female ; Elimination Disorders/epidemiology ; Comorbidity ; Child, Preschool ; Child ; Attention Deficit Disorder with Hyperactivity/classification/*epidemiology ; Anxiety Disorders/epidemiology ; Adolescent

OBJECTIVETo study the clinical features and risk factors of co-morbid tic disorder (TD) in children with attention deficit hyperactivity disorder (ADHD).

METHODSA total of 312 children with ADHD were involved in this study. Subtypes of co-morbid TD, incidences of TD in different subtypes of ADHD (ADHD-I, ADHD-HI and ADHD-C) were observed. Thirteen potential factors influencing the comorbidity rate of TD in ADHD were evaluated by univariate analysis and multiple logistic regression analysis.

RESULTSForty-two of 312 children with ADHD suffered from co-morbid TD (13.5%). Comorbidity rate of TD in children with ADHD-C (24.1%) was significantly higher than in those with ADHD-HI (10.9%) and ADHD-I (8.8%) (P<0.05). There were 21 cases (50.0%) of transient TD, 12 cases (28.6%) of chronic TD, and 9 cases (21.4%) of Tourette syndrome. The univariate analysis revealed 6 factors associated with comorbidity: addiction to mobile phone or computer games, poor eating habits, infection, improper family education, poor relationship between parents and poor relationship with schoolmates. Multiple logistic analysis revealed two independent risk factors for comorbidity: improper family education (OR=7.000, P<0.05) and infection (OR=2.564, P<0.05).

CONCLUSIONSThe incidence of co-morbid TD in children with ADHD is influenced by many factors, and early interventions should be performed based on the main risk factors.

Adolescent ; Attention Deficit Disorder with Hyperactivity ; complications ; Child ; Comorbidity ; Female ; Humans ; Logistic Models ; Male ; Risk Factors ; Tic Disorders ; epidemiology ; etiology

OBJECTIVETo study the epidemiological features of tic disorders (TD) among schoolchildren in Wenzhou area.

METHODSStratified cluster sampling was carried out to investigate TD in 9742 schoolchildren aged 7 to 16 years old in Wenzhou.

RESULTSThe average prevalence rate of TD among school-age children was 104/10 000 (166/10 000 for males, 29/10 000 for females). There was a significantly higher prevalence rate for males than that for females (chi(2) = 43.96, P < 0.001, prevalence ratio = 5.7, prevalence ratio 95% CI: 3.20 - 10.30). The prevalence rates of clinical subtypes in males was significantly higher than that of females while pupils was significantly higher than that in high school students (chi(2) = 11.33, P < 0.01, prevalence ratio = 2.2, prevalence ratio 95% CI: 1.37 - 3.43). Prevalence rate of transient tic disorders (TTD), chronic motor vocal tic disorder (CMVTD), tourette syndrome (TS) were 34/10 000, 27/10 000 and 43/10 000 respectively with the highest among 9-10 years old group. The mean onset age of TD was 8.5 +/- 2.8 years. The peak of onset was among 6-10 year olds. The rate of delayed diagnosis of the disorders was 69.3% and the median in delayed diagnosis was 1.0 year.

CONCLUSIONTD is a common disease with high rate of misdiagnoses among schoolchildren in Wenzhou area. Physicians and population should be trained to identify the syndromes and to practice correct diagnosis and effective treatment as early as possible.

Adolescent ; Child ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Prevalence ; Sex Factors ; Tic Disorders ; epidemiology ; prevention & control ; Tourette Syndrome ; epidemiology ; prevention & control

OBJECTIVETo investigate the epidemiological characteristics of tic disorders (TD) among pupils in the Shunde Longjiang area, and their relationship to trace elements.

METHODSA cross-sectional study of 4062 children aged 6-12 years, who were selected from the Shunde Longjiang area by stratified cluster sampling to investigate the epidemiological characteristics of TD, was conducted, and blood concentrations of trace elements in children with TD were determined. Forty normal children were selected as controls.

RESULTSThe overall prevalence rate of TD was 2.98%; the prevalence rates of transient tic disorder, chronic motor or vocal tic disorder and Tourette's syndrome were 3.62%, 2.39% and 1.21% respectively. Boys had a significantly higher prevalence rate of TD than girls (3.92% vs 1.96%; P<0.05). There were no significant differences in blood copper, manganese and magnesium levels between children with TD and normal children (P>0.05), however, children with TD had a significantly increased blood lead level and significantly decreased blood zinc and iron levels compared with the normal children (P<0.05). No significant differences in trace elements were found between children with different subtypes of TD (P>0.05).

CONCLUSIONSTD is common in children aged 6-12 years and more prevalent in boys than in girls. High blood lead level and zinc and iron deficiencies may be one of the causes of TD, and thus should be considered during therapy.

Child ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Iron ; blood ; Lead ; blood ; Male ; Tic Disorders ; blood ; epidemiology ; Trace Elements ; blood ; Zinc ; blood

Obsessive compulsive disorder with child & adolescent onset (C-OCD) is not a rare disorder. Though OCD patients with prepubertal onset is scarce, the prevalence of OCD with postpubertal, adolescent onset reach nearly that of adult OCD. In clinical features, C-OCD resemble adult OCD. However, the other features of pediatric OCD are different from those of adult OCD. The sex ratio of pediatric OCD is male dominant and C-OCD show high comorbid rate with tic disorder, which is not prevailing in adult OCD. Family data analysis of tic disorder and C-OCD reveal the close genetic linkage between two disorders. Neuroimaging studies of C-OCD indicate very consistent findings in basal ganglia volume change (usually reduction of striatum) that may not be so consistent in adult OCD. SSRIs are less effective in C-OCD and combined therapy with antipsychotics is more frequently needed than adult OCD. In conclusion, child and adolescent OCD can be a distinctive subtype of OCD that is different from adult OCD in many ways.
Adolescent* ; Adult ; Antipsychotic Agents ; Basal Ganglia ; Child* ; Epidemiology ; Genetic Linkage ; Humans ; Male ; Neurobiology ; Neuroimaging ; Obsessive-Compulsive Disorder* ; Prevalence ; Sex Ratio ; Statistics as Topic ; Tic Disorders

OBJECTIVETo examine serum 25-hydroxyvitamin D levels in children with tic disorders (TD) and to explore the relationship between vitamin D level and TD.

METHODSOne hundred and thirty-two children who were diagnosed with TD between November 2016 and May 2017 were enrolled as the TD group, including 8 cases of Tourette syndrome, 32 cases of chronic TD, and 92 cases of transient TD. One hundred and forty-four healthy children served as the control group. Peripheral venous blood samples were collected from each child. Serum levels of 25-hydroxyvitamin D were measured using HPLC-MS/MS. The categories of vitamin D status based on serum 25-hydroxyvitamin D level included: normal (>30 ng/mL), insufficiency (10-30 ng/mL) and deficiency (<10 ng/mL).

RESULTSMean serum level of 25-hydroxyvitamin D in the TD group was significantly lower than that in the control group (P<0.01). The rate of vitamin D insufficiency or deficiency in the TD group was significantly higher than in the control group (P<0.01). Mean serum level of 25-hydroxyvitamin D in the transient tic group was higher than in the TS group (P<0.05).

CONCLUSIONSVitamin D insufficiency or deficiency might be associated with the development of TD, and the level of serum 25-hydroxyvitamin D might be related to the classification of TD.

Child ; Child, Preschool ; Female ; Humans ; Male ; Tandem Mass Spectrometry ; Tic Disorders ; blood ; etiology ; Vitamin D ; analogs & derivatives ; blood ; Vitamin D Deficiency ; complications ; epidemiology