ABSTRACT
Objective: To assess differences in executive functioning between children and adolescents with attention-deficit/hyperactivity disorder (ADHD) comorbid or not with bipolar disorder (BD), and to study the neuropsychological profile of subjects with the comorbidity in a clinical sample from a developing country. Method: Case-control study comparing 23 participants with BD + ADHD and 85 ADHD-only subjects aged 6 to 17 years old. Both groups were drug-free. Executive function domains were assessed with the Stroop Test, the Wisconsin Card Sorting Test, and the Continuous Performance Test II. Results: The group with juvenile BD + ADHD showed a significantly worse performance on the Stroop task, including time in color (p = 0.002), time in color-word (p < 0.001), interference, number or errors in color and color-word (p = 0.001), and number of errors in word cards (p = 0.028). No between-group differences were found in other tests. Conclusions: Our findings suggest that ADHD-only and ADHD + BD do not show differences in inhibitory control and set-shifting domains. However, children and adolescents with BD and comorbid ADHD show greater impairment in processing speed and interference control. This suggests a potentially higher impairment in the dorsolateral prefrontal cortex and may be a potential neuropsychological signature of juvenile BD comorbid with ADHD. .
Subject(s)
Adolescent , Child , Female , Humans , Male , Attention Deficit Disorder with Hyperactivity/physiopathology , Bipolar Disorder/physiopathology , Cognition Disorders/physiopathology , Executive Function/physiology , Case-Control Studies , Comorbidity , Multivariate Analysis , Neuropsychological Tests , Reference Values , Time FactorsABSTRACT
OBJECTIVES: To assess the association between estimated Mental Retardation (MR) and school dropout in a sample of students of the third and fourth grades at state schools in Porto Alegre, the capital of the southernmost state of Brazil. METHOD: In this case - control study, students that dropped out from schools (n=44) and a control group who continued attending schools (n=44) had their intelligence quotient (IQ) determined by the vocabulary and cubes subtests of the Wescheler Intelligence Scale ¾ third edition (WISC¾III). Students with IQ lower than 70 were considered as potential cases of MR. Other prevalent mental disorders in this age range were assessed in both groups using the Schedule for Affective Disorders and Schizophrenia for School¾ Age Children, Epidemiological Version (K-SADS-E). RESULTS: The prevalence of potential MR was significantly higher in the dropped out group than in the control group (p<0.001). Odds ratio for school dropout was significantly higher in the presence of MR even after controlling for potentially confounding factors (age, conduct disorder, grade repetition, family structure and income) (p<0.01). CONCLUSION: Children with IQ lower than 70 (potential MR) were at higher risk for school dropout. These children need to be identified at school and specific educational strategies should be implemented to assure their inclusion in the learning process