Guided by: Submitted by:
Dr. Sujina. C. M., Asha. U. N.
Dept. of Community Medicine, Shehanaaz Begum.T. A.
Govt. Medical College, Silpa. A. R.
Thiruvananthapuram. 2005 MBBS
OBJECTIVE: To find out the risk factors for Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) in children < 15 years of age.
METHOD: We conducted a case control study and compared 50 cases of clinically diagnosed ADHD, ODD and CD with 100 controls who did not have ADHD, ODD and CD. Our cases were those attending Child Psychiatry OPD, Medical College, Thiruvananthapuram. Our tool was an interview schedule. Our study period was from 20th September, 2008 to 30th December, 2008.
RESULTS: By using Chi-square test and Odds Ratio we found out whether there is any association between ADHD, ODD and CD and the factors which we have taken into consideration. We found that according to Chi-square test and Odds Ratio (OR), the determinants Nuclear family (p value=0.00, OR=11.049), Low APGAR Score (p value =0.000, OR=0.05), Low Birth weight (p value =0.000, OR=14.333), High bilirubin level at birth (p value = 0.000, OR=4.889), Developmental delay (p value =0.000, OR=17.975), Family History of Psychiatric illness (p value =0.000, OR=4.889), Substance abuse in family (p value =0.01, OR=3.571), Similar disease in parents’ childhood (p value =0.01, OR=3.128), Similar disease in siblings (p value =0.000, OR=3.457), Integrity of family (p value =0.000, OR=23.81) and Frequent quarrel among the family members (p value =0.000, OR=16.657) are statistically significant. We also found a moderate association between ADHD, ODD and CD and frequent change of caretakers (p value =0.073, OR=6.319). By using logistic regression, we found that the determinants Nuclear family (p value =0.00, OR=11.049, Low APGAR Score (p value =0.000, OR=0.05), High bilirubin level at birth (p value = 0.000, OR=4.889), Developmental delay (p value =0.000, OR=17.975), Family History of Psychiatric illness (p value =0.000, OR=4.889), Integrity of family (p value =0.000, OR=23.81) and Frequent quarrel among the family members (p value =0.000, OR=16.657) are individually significant.
CONCLUSION: From our study, we conclude that ADHD, ODD and CD have a strong association with nuclear family, low APGAR score, low birth weight, high bilirubin level at birth, developmental delay, family history of psychiatric illness, substance abuse in family, similar disease in parents’ childhood, similar disease in siblings, integrity of family and frequent quarrel among family members. Our sample size was too small and this may be the reason that many of the risk factors under consideration were not found to be statistically significant.