No abstract

With the research reported on here we sought to determine whether children with attention-deficit/hyperactivity disorder (ADHD) displayed more symptoms of oppositional defiant disorder (ODD), conduct disorder (CD) and anger, which are categorised as externalising disorders, when contrasted to the control group and, also, whether gender and age impacted these ADHD comorbidities. ADHD is a neurodevelopmental disorder that presents before the age of 12 years according to which an individual displays a recurrent pattern of extreme inattentiveness, overactivity, and impulsiveness that inhibits performance, and is not age-appropriate. ODD is defined as a psychological syndrome characterised by disruptive behaviour, a pattern of anger and irritability, confrontational, and spiteful behaviour. CD is a psychological and behavioural syndrome characterised by difficulties with following rules, recurrent patterns of hostility, destruction, and dishonesty. Anger is a frequent reaction (contrasted to ordinary irritable mood), intense and long-lasting defensive or retaliatory response to perceived provocation or threat, which interferes with normal functioning. Both teacher and parent ratings on the Disruptive Behavior Disorders Scale, and self-report on the Anger Inventory of the Beck Youth Inventories were employed in this investigation. The sample (n = 216) consisted of 216 school children aged 6 to 15 years that were divided into an ADHD group and a matched control group without ADHD (50 boys and 58 girls in each group). The results indicate that children with ADHD displayed notably elevated symptoms of ODD, CD and anger. The externalising disorders are more pronounced in boys with ADHD than in girls. Age had no effect on the results. We recommend that externalising comorbidities should be the target of early interventions. Our findings contribute to the debate about how best to conceptualise ADHD regarding related behavioural and emotional disturbances, and the treatment thereof. Since these symptoms occur during childhood and progress to adolescence, early identification and management may improve the livelihood of those affected.

This study considered whether children with attention-deficit hyperactivity disorder displayed a stronger preference for smaller, more immediate rewards over larger, but delayed rewards (delay aversion) when compared to typically developing controls and, furthermore, whether age and gender influenced their preference in any way. Children, between 6 and 15 years of age, living in Limpopo province of South Africa, participated in the study. Two hundred sixteen children in total (108 with attention-deficit hyperactivity disorder and 108 matched controls without attention-deficit hyperactivity disorder symptoms) were assessed, on a task of delay aversion. The Two Choice Impulsivity Paradigm, which assesses immediate and delayed responses, was administered to both the attention-deficit hyperactivity disorder and control groups. The performance of both groups was compared on the Two Choice Impulsivity Paradigm, and the scores were analysed as a function of gender and age. The attention-deficit hyperactivity disorder group chose significantly more immediate, smaller responses than the neurotypical control group, which preferred significantly more delayed but larger responses. Gender and age did not affect the response choices for both immediate and delayed measurements. Children with attention-deficit hyperactivity disorder show a greater need for more immediate gratification, even if the reward is smaller, than the neurotypical control group who could delay gratification to receive a larger reward. Gender and age did not influence their preferences.

Background Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and risk factors for asthma in adolescents in an LMIC. Methods A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021. Results A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctordiagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01. Conclusion Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.

Background Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder reported in both children and adults; it is often associated with a variety of executive functioning deficits. Aim This study investigated the extent to which working memory and set-shifting are impaired in school children with and without ADHD. Setting This included primary schools in Lepelle-Nkumpi Municipality in Limpopo province, South Africa. Methods A total of 216 children (108 screened positive for ADHD and 108 matched controls without ADHD symptoms), aged between 6 and 15 years, participated in the study. The performance of the two groups was compared on tests of working memory (Forward and Backward Digit Span subtests of the Wechsler Intelligence Scale for Children – Fourth Edition) and set-shifting (Trail Making Test Part B). The scores were analysed as a function of gender and age. Results The group with possible ADHD performed worse than the neurotypical control group on tasks of working memory and set-shifting. The results did not indicate that gender affected performance. However, the younger age group performed worse than the older children. Conclusion Children classified as ADHD showed significantly more impairments in working memory and set-shifting than neurotypical controls. Neither test showed any significant difference between male and female performance, whilst age was shown to affect performance on both tests. Early identification and treatment of children with attention-deficit hyperactivity disorder are crucial to their well-being.