[The use of strength and difficulties questionnaire in psychosocial evaluation and attention deficit hyperactivity disorder screening in preterm infants]

Abstract

Introduction: Behavioural disorders and learning disabilities are often recognised in<1,500g or<32 weeks very low birth weight (VLBW) infants. There is very limited data in the Spanish population.

Objective: To determine the presence of psychosocial disorders in preterm infants at 6 years of age, as assessed by the strength and difficulties (SDQ) questionnaire, in comparison to a reference population. To set a cut-off value to use SDQ as a screening tool for attention deficit hyperactivity disorder (ADHD) in the preterm child.

Participants and methods: A prospective observational study was conducted on premature children assessed at 6 years of age using the SDQ. Perinatal variables, neurodevelopment, and diagnosis of ADHD, according to the DSM-5, were collected.

Results: A total of 214 children who met all the requirements, were included. When compared with the reference population they had significantly higher scores in emotional symptoms, in peer relationships, and in the total score of the test. The hyperactivity scale and the total test score are good predictors of a diagnosis of ADHD, with an area under the ROC curve of 0.83 (95% CI: 0.76-0.90) for hyperactivity, and 0.87 (95% CI: 0.80-0.93) for the total score. The scores for hyperactivity and the total test, from which the screening for ADHD could be considered positive would be≥6 and≥13 respectively, and a combination of hyperactivity≥5 and total score≥12.

Conclusions: Preterm children are at higher risk of emotional and peer relationship problems than those born full term. The SDQ test could be used for ADHD screening.

Keywords: Affective symptoms; Attention deficit disorder with hyperactivity; Foetal growth retardation; Premature infant; Prematuro; Recién nacido de muy bajo peso; Restricción del crecimiento intrauterino; Social behaviour disorders; Síntomas afectivos; Trastorno por déficit de atención e hiperactividad; Trastornos del comportamiento social; Very low birth weight infant.