ADHD in Turkish college students: prevalence and co-existing mental and physical health problems and life style habits Aynur Görmez, Ayşe Kurtulmuş,Emel Koçer, Rabia Boyraz, Mehmet Akif Cansız YRD. DOÇ. DR. AYNUR GÖRMEZ MD, MRCPSYCH İSTANBUL MEDENIYET ÜNIVERSITESI, PSIKIYATRI ANABILIM DALı 04.10.17 53. UPK, BURSA
Introduction persistence of ADHD symptoms into adulthood : 4-76% Core symptoms of ADHD - inattention, hyperactivity and impulsivity- can change over time Prevalence of ADHD was 2-7% in college students Do worse at academic work Depression X 3 Anxiety X 2 Lower education levels, incapacity to work
Objective to investigate the prevalence of ADHD symptoms among university students at Bezmialem Uni. their co-occurrence with symptoms of anxiety and depression and life-time psychiatric comorbidities to examine the relationship of ADHD symptoms with some lifestyle habits and medical comorbidities.
Method 485 undergraduate students filled out the Adult ADHD Self-Report Scale (ASRS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI purpose-designed structured socio-demographic form.
Participants 485 students in five different faculties 347 (71.5%) females and 134 (27.6%) males; 4 (0.8%) participants did not indicate their gender. The average age was 21.04 years (range 17-29, SD: 1.895).
Results SPPS v. 20, p<0.05 Mean ASRS score was 27.98±9.60. 30 students were selected for ADHD group when 1.5 SD above the mean ( 42. 38) was accepted as ASRS cut-off score Prevalence of ADHD came out 6.19%.
Results no gender differences between groups; the proportion of ADHD was not significantly different between males and females (8.2% vs 5.5%, χ 2 = 1.235, df=1, p=0.27) Among ADHD group, only 8 students (26.7%) reported to have had childhood diagnosis of ADHD.
Non-ADHD Group ADHD Group Total N % N % N % p χ2 Sex Male 123 27,3 11 36,7 134 27,86 0.27 1,24 Female 328 72,7 19 63,3 347 72,14 Habits Smoking 49 10,09 6 20 55 11,5 0,138 2,26 Alcohol 53 11,9 4 13,3 57 11,9 0,49 0,6 Night eating 177 39,3 19 69,3 196 40,8 0,009* 6,71 Binge eating 178 39,9 20 66,7 198 41,6 0,004* 8,28 Lifelong Psychiatric Comorbidity 146 33,18 16 53,33 162 34,47 0,025* 5,05 Depressivedisorder 36 8,2 10 34,5 46 9,8 0,00* 21,2 Anxietydisorder 48 10,9 10 35,7 58 12,4 0,001* 14,92 Eating disorder 59 13,4 4 14,3 63 13,5 0,781 0,02 Sleep difficulties 87 19,8 14 48,3 101 21,6 0,002* 13,02 Comorbidmedicalconditions Allergicdisorder 152 34,5 14 48,3 166 35,4 0,161 2,24 Headache 148 33,6 16 57,1 164 35 0,014 6,43
Results Life-time psychiatric comorbidities and Beck scores More lifetime psychiatric disorders compared to non-adhd group (53.33% vs. 33.18%; χ 2 = 5.049, df=1, p= 0.025). More lifetime depressive disorder was 34.5% for the ADHD group and 8.2% for comparison group (χ 2 =21.20, df =1, p= 0.00). Higher rate for having a lifetime anxiety disorder (35.7% vs 10.7%, χ 2 =14.92, df =1, p= 0.001) A total of 13(2.6%) students reported to have bipolar disorder and of these students only one of them was in ADHD group. Life time eating disorder was not significantly different between groups (%14.3 in ADHD group and 13.4% in non-adhd group, p= 0.781). 13.4% in non-adhd group, p= 0.781).48.3% of students in ADHD group vs 19.8% of students in non- ADHD group have reported sleep difficulties and the difference between groups was statistically significant (p=0.002). There were significant differences in both the anxiety and depression scores of ADHD and non-adhd groups (p=0.00).
Results When regression analysis was carried out: ADHD as the dependent variable; and sex, age, lifetime psychiatric disorder, BAI and BDI as independent variables, the only significant variable influencing whether being classified as having ADHD was BAI scores
Results-Eating habits Students in ADHD group reported more frequent night eating and binge eating behaviors (63.33% vs 39.33%, χ 2 = 6.705, df=1, p=0.01 and 66.67% vs 39.91%, χ 2 = 8.283, df=1, p=0.004 When logistic regression analysis was conducted to estimate the effects of cofactors, such as sex, BAI and BDI scores, on the relationship between ADHD and eating behaviors, the differences were not statistically significant (p=0.11 for night eating and p=0.12 for binge eating behavior)(table 3).
Results-Smoking & Drinking A fifth of the students in ADHD group (20.0%) and 10.9% of students in non-adhd group were smokers. But, this difference was not statistically significant (χ 2 =2.29, df=1, p=0.138). The prevalence of alcohol use and the amount of weekly alcohol consumption did not differ between ADHD and non- ADHD groups (p=0.77 and p=0.907, respectively)
Results- Comorbid Medical Conditions The proportion of students who had allergic disorders (asthma and/or allergy) was 48.3% in ADHD group vs 34.5% in non-adhd group. This difference between groups was not statistically significant (χ 2 = 2.243, df=1, p= 0.161) (Table 1). Students in ADHD group were more likely to have headache than students in non-adhd group (χ 2 = 6.439, df=1, p=0.014)(table 1) and this difference was statistically significant after controlling for confounding factors such as sex, BDI and BAI scores (p=0.038)
Discussion Self-report ASRS: based on DSM-4 Prevalence of adult ADHD has been reported as 2-8% in most studies Only 26 % of students with ADHD symptoms reported a childhood diagnosis of ADHD: missed / underdiagnosing seemingly treatment resistant ADHD : consider psychiatric comorbidity!! More evidence needed for medical comorbidities Evidence is accumulating for lifestyle habits esp. eating habits and obesity
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