Background: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common behavioral problems among children around the world including Thailand. The disease affects their life, parents and community when left untreated. Most information concerning ADHD in Thailand derives from hospital based studies. The present study aimed to determine the prevalence and associated factors of ADHD in a remote rural community. Methods:A total of 495 primary school children were screened using the SNAP-IV. Positive screening cases were then diagnosed by pediatric psychiatrists according to the DSM-V criteria. Standardized questionnaires were used to collect demographic data and associated factors. A qualitative study using focus group discussions and indepth interviews was conducted to determine knowledge and perceptions regarding ADHD among teachers and main guardians. Results:The prevalence of ADHD among children was 2.2%. Univariate and multivariate analysis showed that children with ADHD were associated with both familial and individual factors including being repeatedly inattentive or hyperactive in class, suspended from school, and changing school, a history of bullying and main guardians were not parents. Qualitative data showed that both main guardians and teachers had inadequate knowledge and misperceptions regarding children with ADHD. The local health care system could not detect this problem so the children with ADHD were not properly treated. Conclusion:Our data emphasized that ADHD was a problem in this remote rural community. Screening tests and referral systems for ADHD should be provided for rural communities.

Background: The COVID-19 pandemic has impacted on medical education and other areas of life causing psychological distress. Objectives: The study aimed to assess psychological impact and coping and to identify factors associated psychological impact among medical students. Methods: An online cross-sectional study was conducted at Phramongkutklao College of Medicine (PCM) in April 2021. All medical students were invited to complete a standardized online questionnaire for demographics data, impact of COVID-19, coping, fear of illness and virus evaluation (FIVE). The Depression Anxiety Stress Scales (DASS-21) Thai version was used to assess the psychological impact. The factors associated with depression, anxiety and stress were analyzed using logistic regression analysis. Results: In total, 256 medical students completed the questionnaire. Of these, 54.7% reported having psychological impact, 43.4% depression, 36.7% anxiety and 29.7% stress. Depression was associated with preclinical students (adjusted OR(AOR) =3.03, 95% confidence interval (95% CI) =1.54-5.97), sleep problem (AOR =2.20, 95% CI=1.16-4.16) and extreme deterioration of family income (AOR =7.27, 95% CI=1.81-29.29). Anxiety was associated with preclinical students (AOR =3.20, 95% CI=1.52-6.72), COVID-19 like symptoms (AOR =2.93, 95% CI=1.26-6.83), slight problems adjusting to new learning methods (AOR =6.11, 95% CI=1.54-24.24) and extreme deterioration of family income (AOR =8.29, 95% CI=1.44-47.59). Stress was associated with preclinical students (AOR =3.84, 95% CI=1.75-8.40), COVID-19-like symptoms (AOR =3.54, 95% CI=1.53-8.19), and no confidence in COVID-19 policy of PCM (AOR =2.3, 95% CI=1.06-4.98). A positive correlation between Fear of Illness and Virus Evaluation (FIVE) and psychological impact was observed (r=0.449; p<0.001). Common coping activities were the use of social media, video chats and exercise. Conclusion: A high prevalence of psychological impact was observed among medical students during the COVID-19 pandemic. To establish psychological support and resilience, training is needed to improve mental wellbeing and prepare medical students to cope with unprecedented situations.