Risk factors influencing severity of attention deficit hyperactivity disorder in a sample of preparatory school students in Cairo.

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders. Severity of symptoms is associated with more behavioral problems, poor academic performance, and persistence of symptoms into adulthood.

Methods: To examine the clinical and social correlates that may be identified as risk factors associated with ADHD severity in a sample of adolescent ADHD school students. A total of 925 students were recruited from two public and two private schools from eastern Cairo. They were interviewed using Conners-Wells Adolescent Self-Report-short version (CASS-S); students scoring more than 65 were further interviewed with Kiddie Schedule for Affective Disorders and Schizophrenia-present and lifetime version (K-SADS-PL) to confirm the diagnosis, then Conners-Wells Adolescent Self-Report-long version (CASS-L) to assess severity and Wechsler Intelligence Scale for Children (WISC) to ascertain intellectual ability.

Results: About 10.3% of cases were severe, 5.7% were moderate, and 83.9% were mild. Severity was significantly associated with female gender, psychiatric comorbidity, family problems, conduct symptoms, and poor anger management. Diagnostic and Statistical Manual of Mental Disorders (4th ed.) ( DSM-IV) hyperactive-impulsive type was the only predictive factor of ADHD severity.

Conclusions: The diagnosis of hyperactive-impulsive subtype may predict the severity of ADHD symptoms.