European Child & Adolescent Psychiatry

, Volume 15, Issue 5, pp 292–299 | Cite as

Co-existing symptoms and risk factors among African school children with hyperactivity-inattention symptoms in Kinshasa, Congo

  • Espérance Kashala
  • Astri Lundervold
  • Kristian Sommerfelt
  • Thorkild Tylleskär
  • Irene Elgen
ORIGINAL CONTRIBUTION

Abstract

The aims of the study were to explore hyperactivity–inattention (HI) symptoms and co-existing symptoms of emotional and behavioural problems among African school children and their relationship with health status, socio-demographic factors, and school performance. Method: A case–control approach was used. The Strengths and Difficulties Questionnaire (SDQ) was used to explore the co-existing emotional and behavioural symptoms and a semi-structured interview with parents to explore the socio-demographic variables. The sample included 357 school children at the age of 7–9 years: 183 children were defined as cases, defined by abnormal scores on the SDQ-HI scale and 174 randomly selected children among those with normal scores on the SDQ-HI were defined as controls. No age and gender differences were noticed between the two groups. Results: A younger maternal age at childbirth, and poor school performances were more frequent among cases than controls. Three quarter of the hyperactive-inattentive children had co-existing symptoms according to SDQ, the most common being conduct problems. Conclusion: As in other cultures, co-existence of HI symptoms and emotional and behavioural problems was found in this African setting. Further validation of behavioural screening instruments in African children is called for.

Keywords

hyperactivity–inattention SDQ co-existing symptoms socio-demographic factors 

References

  1. 1.
    Ashenafi Y, Kebede D, Desta M, Alem A (2000) Socio-demographic correlates of mental and behavioural disorders of children in southern Ethiopia. East Afr Med J 77:565–569PubMedGoogle Scholar
  2. 2.
    Barkley RA (1998) Attention deficit hyperactivity disorder: a handbook for diagnosis and treatment, 2nd edn. Guilford Press, New yorkGoogle Scholar
  3. 3.
    Barkley RA (2003) Issues in the diagnosis of attention-deficit/hyperactivity disorder in children. Brain Dev 25:77–83PubMedCrossRefGoogle Scholar
  4. 4.
    Biederman J, Milberger S, Faraone SV, Kiely K, Guite J, Mick E et al (1995) Impact of adversity on functioning and comorbidity in children with attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 34:1495–1503PubMedCrossRefGoogle Scholar
  5. 5.
    Biederman J, Milberger S, Faraone SV, Kiely K, Guite J, Mick E et al (1995) Family-environment risk factors for attention-deficit hyperactivity disorder. A test of Rutter’s indicators of adversity. Arch Gen Psychiatry 52:464–470PubMedGoogle Scholar
  6. 6.
    Busch B, Biederman J, Cohen LG, Sayer JM, Monuteaux MC, Mick E et al (2002) Correlates of ADHD among children in pediatric and psychiatric clinics. Psychiatr Serv 53:1103–1111PubMedCrossRefGoogle Scholar
  7. 7.
    Faraone SV, Biederman J, Mick E, Doyle AE, Wilens T, Spencer T et al (2001) A family study of psychiatric comorbidity in girls and boys with attention-deficit/hyperactivity disorder. Biol Psychiatry 50:586–592PubMedCrossRefGoogle Scholar
  8. 8.
    Gillberg C (2003) Deficits in attention, motor control, and perception: a brief review. Arch Dis Childhood 88:904–910CrossRefGoogle Scholar
  9. 9.
    Gillberg C, Gillberg IC, Rasmussen P, Kadesjo B, Soderstrom H, Rastam M et al (2004) Co-existing disorders in ADHD – implications for diagnosis and intervention. Eur Child Adolesc Psychiatry 13(Suppl 1):I80–92PubMedGoogle Scholar
  10. 10.
    Goodman R (1997). The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–586PubMedGoogle Scholar
  11. 11.
    Goodman R (2001) Psychometric properties of the Strengths and Difficulties Questionnaire. J Am Acad Child Adolesc Psychiatry 40:1337–1345PubMedCrossRefGoogle Scholar
  12. 12.
    Goodman R, Ford T, Corbin T, Meltzer H (2004) Using the Strengths and Difficulties Questionnaire (SDQ) multi-informant algorithm to screen looked-after children for psychiatric disorders. Eur Child Adolesc Psychiatry 13(Suppl 2):II25–31PubMedGoogle Scholar
  13. 13.
    Kadesjo B, Gillberg C (2001) The comorbidity of ADHD in the general population of Swedish school-age children. J Child Psychol Psychiatry 42:487–492PubMedCrossRefGoogle Scholar
  14. 14.
    Kashala E, Elgen I, Sommerfelt K, Tylleskar T (2005) Teacher ratings of mental health among school children in Kinshasa, Democratic Republic of Congo. Eur Child Adolesc Psychiatry 14:208–215PubMedCrossRefGoogle Scholar
  15. 15.
    Kebede D, Alem A, Rashid E (1999) The prevalence and socio-demographic correlates of mental distress in Addis Ababa, Ethiopia. Acta Psychiatr Scand Suppl 397:5–10PubMedGoogle Scholar
  16. 16.
    Landgren M, Kjellman B, Gillberg C (1998) Attention deficit disorder with developmental coordination disorders. Arch Dis Childhood 79:207–212CrossRefGoogle Scholar
  17. 17.
    Meltzer H, Gatward R, Goodman R, Ford T (2000) Mental health of children and adolescents in Great Britain. Office for National Statistics, LondonGoogle Scholar
  18. 18.
    Muris P, Meesters C, Van Den Berg F (2003). The Strengths and Difficulties Questionnaire (SDQ). Further evidence for its reliability and validity in a community sample of Dutch children and adolescents. Eur Child Adolesc Psychiatry 12:1–8PubMedCrossRefGoogle Scholar
  19. 19.
    Peris T, Hinshaw S (2003). Family dynamics and preadolescent girls with ADHD: the relationship between expressed emotion, ADHD symptomatology, and comorbid disruptive behavior. J Child Psychol Psychiatry 44:1177–1190PubMedCrossRefGoogle Scholar
  20. 20.
    Raven JC (1965) Guide to using the coloured progressive matrices. HK Lewis, LondonGoogle Scholar
  21. 21.
    Scahill L, Schwab-Stone M, Merikangas KR, Leckman JF, Zhang H, Kasl S (1999) Psychosocial and clinical correlates of ADHD in a community sample of school-age children. J Am Acad Child Adolesc Psychiatry 38:976–984PubMedCrossRefGoogle Scholar
  22. 22.
    Schubiner H, Tzelepis A, Milberger S, Lockhart N, Kruger M, Kelley BJ et al (2000) Prevalence of attention-deficit/hyperactivity disorder and conduct disorder among substance abusers. J Clin Psychiatry 61:244–251PubMedGoogle Scholar
  23. 23.
    Souza I, Pinheiro MA, Denardin D, Mattos P, Rohde LA (2004) Attention-deficit/hyperactivity disorder and comorbidity in Brazil: comparisons between two referred samples. Eur Child Adolesc Psychiatry 13:243–248PubMedCrossRefGoogle Scholar
  24. 24.
    Waxmonsky J (2003) Assessment and treatment of attention deficit hyperactivity disorder in children with comorbid psychiatric illness. Curr Opin Pediatr 15:476–482PubMedCrossRefGoogle Scholar
  25. 25.
    Woerner W, Becker A, Rothenberger A (2004) Normative data and scale properties of the German parent SDQ. Eur Child Adolesc Psychiatry 13(Suppl 2):II3–10PubMedGoogle Scholar
  26. 26.
    Wolraich M, Hannah J, Pinnock T (1996) Comparison of diagnostic criteria for attention-deficit hyperactivity disorder in a county-wide sample. J Am Acad Child Adolesc Psychiatry 35:319–324PubMedCrossRefGoogle Scholar
  27. 27.
    Wolraich ML, Lambert W, Doffing MA, Bickman L, Simmons T, Worley K (2003) Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population. J Pediatr Psychol 28:559–567PubMedCrossRefGoogle Scholar
  28. 28.
    Zuddas A, Ancilletta B, Muglia P, Cianchetti C (2000) Attention-deficit/hyperactivity disorder: a neuropsychiatric disorder with childhood onset. Eur J Paediatr Neurol 4:53–62PubMedCrossRefGoogle Scholar

Copyright information

© Steinkopff Verlag Darmstadt 2006

Authors and Affiliations

  • Espérance Kashala
    • 1
    • 2
  • Astri Lundervold
    • 3
  • Kristian Sommerfelt
    • 4
  • Thorkild Tylleskär
    • 2
    • 4
  • Irene Elgen
    • 4
  1. 1.Dept. of NeurologyKinshasa University HospitalKinshasaDem. Rep. of Congo
  2. 2.Centre for International HealthUniversity of BergenBergenNorway
  3. 3.Dept. of Biological and Medical PsychologyUniversity of BergenBergenNorway
  4. 4.Dept. of PaediatricsHaukeland University HospitalBergenNorway

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