Abstract

Ali Al Kaissi*, Farid Ben Chehida, Vladimir Kenis, Wolfgang Brozek, Franz Grill, Rudolf Ganger, Susanne Gerit Kircher

ABSTRACT

Objective: Attention deficit hyperactivity disorder (ADHD) is a group of behavioral symptoms that include hyperactivity and impulsiveness. The etiological understanding is somehow controversial. We aimed to study the etiological understanding in a remarkable number of children and adults with various orthopedic problems in which (ADHD) was the earliest feature and was considered as a diagnosis. Material and Methods: 47 children and adolescent (5females and 42 males) of age range of (7-17 years) were sought in our departments from the period of 1998-2012. Prior to the development of variable forms of bone disorders, ADHD was the earliest feature. Clinical examination of parents and multigenerational family tree analyses was fundamental. Eventually phenotypic and genotypic correlation was the baseline tool of documentation. Results: ADHD was a symptom complex rather than a diagnosis in all patients we sought and a number of serious heritable disorders such as; hamartoneoplastic disorders (neurofibromatosis type I, NF-I) in 34 patients(72.3%), syndromic craniosynostosis (3MC, hypophosphataemic rickets) in 3 patients (6.4%) , mucopolysaccharidosis type II (Hunter syndrome) and type III (Sanfilippo syndrome) in one patient (2.1%) and 2 patients (4,3 %) respectively, and in 7 adult patients with XXY syndrome (14,9 %) were diagnosed accordingly. Conclusion: The term ADHD is classically used as a diagnostic entity in accordance and as defined by DSM-5. We wish to underline that these children were not referred to our departments on the premise that they were ADHD patients. The referral was because they starting to develop a diversity of skeletal deformities. Our task was to categorize these children in accordance with their phenotypic and genotypic correlation. Therefore, the usage of stimulant drugs should not be issued, unless a complete clinical documentation is established and the etiological understanding is reached. Our findings confirm the continuity of ADHD beyond the adolescent as a symptom complex rather than a diagnosis.