Archives of Disease in Childhood | 2019
G253(P)\u2005An audit of ADHD patients attending scottish nhs community child health clinics
Abstract
ADHD is the commonest childhood neurodevelopmental disorder that begins in childhood and persists into adulthood, causing multi-domain impairment and three core symptoms of inattention, hyperactivity, and impulsivity. Objectives We aimed to analyze the cohort of children and young people with ADHD seen in two Community Paediatric clinics of a Mid-Eastern Scottish NHS Trust over a one-year period. Methods Medical records of all patients seen in the outpatient clinics between June 2016 and May 2017 were retrospectively reviewed. No identifiable patient record was used and no research ethical approval was required. ADHD was diagnosed using validated SNAP-IV questionnaires. The socio-economic status (SES) of each patient was estimated using the Scottish Index of Multiple Deprivation (SIMD 2016). Spearman’s rank correlation coefficient was used to determine the relationship between the prevalence of ADHD in different socioeconomic groups. Results A total of 93 out of 543 patients (17%) were diagnosed with ADHD, corresponding to 1.5 per 1000 of children’s population (0–15\u2009years), aged between 5 years and 18 years (Average of 11\u2009years) and 82% males. Each patient had 2 to 3 other co-morbid neurodevelopmental problems (NDPs) (ranging from 1 to 8). The commonest co-morbidities were difficulties with sleep (52%), behaviour (32%), coordination (25%), social communication concerns (24%), and emotional problems (19%). Girls had a higher number of co-morbidities (3 vs 2) and other healthcare professionals (2 vs 1) compared to the boys. There were statistically significant associations between the prevalence of ADHD and the SES of the patients (figure 1) and between the number of co-morbidities and the number of professionals caring for each patient (figure 2). The commonest multi-agency professionals involved included the CAMHS (33%), OT (19%), Educational Psychologists (14%), General Paediatricians (14%) and Clinical Psychologists (12%). Conclusion This study highlights the significant Public Health importance of childhood ADHD requiring high levels of integrated multi-professional involvement. This study confirms that the socio-economic characteristics of the children population have a significant influence on the prevalence of ADHD. The Scottish Government’s various initiatives to reduce health and wellbeing inequalities will help to reduce the overall burden of these disorders in the short- and long-terms.