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Abstract(s)
Introdução: A Perturbação de Hiperatividade com Défice de Atenção é a perturbação de neurocomportamental mais comum da infância e carateriza-se por incapacidade de focar e suster a atenção, controlar o nível de atividade e moderar as ações impulsivas, o que leva ao desenvolvimento de comportamentos discordantes com a idade e nível de desenvolvimento. É uma doença com elevada prevalência, mais comum em indivíduos do género masculino e cujo diagnóstico assenta em critérios clínicos e que, pelas implicações ao nível socioeducacional necessita de uma abordagem multidisciplinar no sentido de reduzir as complicações a curto e longo prazo.
Métodos: Realizou-se um estudo retrospectivo, transversal, das crianças com Perturbação de Hiperatividade com Défice de Atenção medicadas seguidas na consulta de desenvolvimento do Centro Hospitalar da Cova da Beira. Os dados foram recolhidos entre Setembro de 2011 e Março de 2012, através da consulta dos processos eletrónicos e em papel.
Resultados: Estudaram-se 69 crianças medicadas com metilfenidato, sendo 17,4% do género feminino e 82,6% do género masculino, com idades compreendidas entre os 7 e os 16 anos de idade, com média de idades de 10,6±2,3. Das 69 crianças 43,5% apresentavam uma perturbção do subtipo mista, 31,9% do subtipo hiperativo e e 24,6% do subtipo desatento. A média do QI era de 87,5±1,7. Obtiveram-se resultados estatisticamente significativos que relacionam os sintomas com o quociente de inteligencia total (p=0,021), com o quociente de inteligencia verbal (p=0,029), com o quociente de inteligencia de realização (p=0,033) e com a Organização Percetiva (p=0,024). Obteve-se significância na diferença entre o quociente de inteligencia verbal e o quociente de inteligencia de realização (p=0,033), que se traduz num quociente de inteligencia de realização superior ao quociente de inteligencia verbal. Obteve-se ainda significância na relação entre os sintomas e a medicação efetuada (p=0,037). Não se obteve significância em relação à analise estatistica dos traçados eletroencefalograficos que foram realizados em 23 das crianças.
Conclusão: Os resultados obtidos no presente estudo permitem-nos concluir que, nesta população de crianças, quanto mais elevado o quociente de inteligencia total, quociente de inteligencia verbal, o quociente de inteligencia de realização e a subescala Organização Percetiva melhor é o controlo dos sintomas com a medicação efetuada. Os resultados deste estudo apontam para uma diferença significativa entre o quociente de inteligencia verbal e o quociente de inteligencia de realização, no entanto esta diferença parece ser desadequada na prática clínica, para diagnóstico de perturbação de hiperatividade com défice de atenção, devido à sua elevada variabilidade. Concluiu-se ainda, no que diz respeito à medicação, que uma percentagem elavada das crianças que se encontram medicadas com metilfenidato 18mg, 20 mg ou 36 mg se encontram na categoria “Sem sintomas/Poucos sintomas”; contrapondo com as dosagens de 30 e 40 mg que apresentam um numéro comparativamente elevado de crianças na categoria “alguns sintomas”. O estudo eletroencefalográfico não permitiu significância estatística em nenhuma das análises provavelmente devido ao número reduzido de crianças que foram submetidas ao exame.
Introduction: Attention deficit hyperactivity disorder is the most common neurobehavioral disease in childhood and it is characterized by the inability to focus and maintain attention, control the levels of activity and moderate impulsive action, which lead to the development of a behavior that is discordant with age and level of development. It is a highly prevalent disease, more common in males and its diagnosis is based on clinical criterion and because of its social and educational implications it requires a multidisciplinary approach with the aim to reduce the short and long term complications. Methods: We conducted a transversal retrospective study of the medicated children with attention deficit hyperactivity disorder that were being treated in the developmental consultation of the Centro Hospitalar da Cova da Beira. The data were collected between September of 2011 and March of 2012, consulting the electronic registry and patient folders. Results: We studied 69 children medicated with methylphenidate, 17,4% were females and 82,6% were males, with ages between 7 and16 years old, with a mean age of 10,6±2,3. Of the total 69, 43,5% had the mixed subtype, 31,9% had the hyperactive subtype and 24,% had the inattentive subtype. The mean intelligence quotient was 87,5±1,7. We obtained statistically significant results that relate the symptoms with the total intelligence quotient (p=0,021), with the verbal intelligence quotient (p=0,029), with the performance intelligence quotient (p=0,033) and with perceptual organization (p=0,024). We obtained significance in the difference between the verbal intelligence quotient and the performance IQ (p=0,033), which translates into a performance intelligence quotient higher than the verbal intelligence quotient. We also obtained significance in relating the symptoms with the medication (p=0,037). We did not obtain significance concerning the electroencephalographic studies of 23 of the children. Conclusion: The obtained results allow us to conclude that, in this population of children, the higher the intelligence quotient, the verbal intelligence quotient, the performance intelligence quotient and the perceptual organization subscale score, the better the symptoms can be controlled with the medication that is being administered. The results of this study point to a significant difference between the verbal intelligence quotient and the performance intelligence quotient, however this difference seems to be inadequate to be used in clinical practice because it is highly variable. We concluded that, regarding the medication, a high percentage of children medicated with 18mg, 20 mg or 36 mg of methylphenidate are in the category “Without symptoms/Few symptoms”; as opposite to a comparatively high number of children in the category “Some symptoms” that are using the 30 or 40 mg dose. The electroencephalographic study did not allow statistical significance in any of the analysis probably because of the small number of children on which it was performed.
Introduction: Attention deficit hyperactivity disorder is the most common neurobehavioral disease in childhood and it is characterized by the inability to focus and maintain attention, control the levels of activity and moderate impulsive action, which lead to the development of a behavior that is discordant with age and level of development. It is a highly prevalent disease, more common in males and its diagnosis is based on clinical criterion and because of its social and educational implications it requires a multidisciplinary approach with the aim to reduce the short and long term complications. Methods: We conducted a transversal retrospective study of the medicated children with attention deficit hyperactivity disorder that were being treated in the developmental consultation of the Centro Hospitalar da Cova da Beira. The data were collected between September of 2011 and March of 2012, consulting the electronic registry and patient folders. Results: We studied 69 children medicated with methylphenidate, 17,4% were females and 82,6% were males, with ages between 7 and16 years old, with a mean age of 10,6±2,3. Of the total 69, 43,5% had the mixed subtype, 31,9% had the hyperactive subtype and 24,% had the inattentive subtype. The mean intelligence quotient was 87,5±1,7. We obtained statistically significant results that relate the symptoms with the total intelligence quotient (p=0,021), with the verbal intelligence quotient (p=0,029), with the performance intelligence quotient (p=0,033) and with perceptual organization (p=0,024). We obtained significance in the difference between the verbal intelligence quotient and the performance IQ (p=0,033), which translates into a performance intelligence quotient higher than the verbal intelligence quotient. We also obtained significance in relating the symptoms with the medication (p=0,037). We did not obtain significance concerning the electroencephalographic studies of 23 of the children. Conclusion: The obtained results allow us to conclude that, in this population of children, the higher the intelligence quotient, the verbal intelligence quotient, the performance intelligence quotient and the perceptual organization subscale score, the better the symptoms can be controlled with the medication that is being administered. The results of this study point to a significant difference between the verbal intelligence quotient and the performance intelligence quotient, however this difference seems to be inadequate to be used in clinical practice because it is highly variable. We concluded that, regarding the medication, a high percentage of children medicated with 18mg, 20 mg or 36 mg of methylphenidate are in the category “Without symptoms/Few symptoms”; as opposite to a comparatively high number of children in the category “Some symptoms” that are using the 30 or 40 mg dose. The electroencephalographic study did not allow statistical significance in any of the analysis probably because of the small number of children on which it was performed.
Description
Keywords
Hiperactividade - Crianças - Défice de atenção Hiperactividade - Crianças - Metilfenidato Crianças - Quociente de inteligência Electroencefalograma - Crianças
Citation
Publisher
Universidade da Beira Interior