Emotional/Behavioural Problems and Functional Impairment in Children with Attention-Deficit/Hyperactivity Disorder

Abstract

© 2020 Hong Kong Academy of Medicine Press. All rights reserved. Objective: This study aimed to compare the emotional/behavioural problems and functional impairment between early school-age children with attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls. Factors associated with behavioural problem scores were also evaluated. Methods: Children aged 6 to 10 years who were diagnosed with ADHD based on the Swanson, Nolan and Pelham version IV Scale (SNAP-IV) and the DSM-5 criteria for ADHD were compared with age- A nd sex-matched controls with negative SNAP-IV results in terms of emotional/behavioural problems (as assessed by the Child Behavioural Checklist) and functional impairment (as assessed by the Strength and Difficulties Questionnaire). Results: 40 children with ADHD and 40 non-ADHD controls with a mean age of 8.40 ± 1.44 years were included. The ADHD group scored significantly higher than controls in terms of all eight subscales of emotional/behavioural problems (p<0.001 to p<0.01). Regarding functional impairment, the ADHD group reported significantly higher scores than controls in terms of total difficulties, conduct problems, and hyperactivity (all p<0.01); and significantly lower prosocial scores (p<0.03). In the multiple linear regression analysis, among the ADHD group, comorbid medical disorders were associated with higher total problem score, internalising behaviour problems score, and externalising behaviour problems score; whereas combined subtype ADHD was associated with higher total difficulties score. Conclusions: Early school-age children with ADHD have more emotional/behavioural problems and functional impairment than non-ADHD controls, and they need further evaluation and intervention for psychosocial functioning, particularly those with comorbid medical disorder or combined subtype ADHD.