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Association of Liver Transplant and Attention-Deficit Hyperactivity Disorder: A Single-Center Experience
Yildiz Marangoz1, Burcu Akin Sari, Figen Özçay
1From the Department of Pediatrics, Faculty of Medicine, Baskent University, Ankara, Turkey.
Insights
Accurate diagnosis of attention-deficit hyperactivity disorder (ADHD) in pediatric liver transplant recipients relies on clinical examination over standardized tests. This finding is crucial for effective ADHD management in this vulnerable population.
Area of Science:
- Pediatric Gastroenterology
- Child and Adolescent Psychiatry
- Transplant Surgery
Background:
- Children undergoing liver transplant are at risk for neurodevelopmental disorders.
- Accurate diagnosis of attention-deficit hyperactivity disorder (ADHD) is essential for appropriate management and improved outcomes in pediatric liver transplant recipients.
Purpose of the Study:
- To determine the prevalence of ADHD in pediatric liver transplant recipients.
- To evaluate the most accurate diagnostic methods for ADHD in this specific patient group.
Main Methods:
- A prospective cohort study included 62 children (6-18 years) post-liver transplant.
- ADHD diagnosis was assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria.
- Evaluations included the Kiddie Schedule for Affective Disorders and Schizophrenia, Conners Parent Rating Scale, and Conners Teacher Rating Scale, alongside clinical examination.
Main Results:
- ADHD prevalence varied significantly by assessment tool: Kiddie Schedule (24.5%), Conners Parent Rating Scale (45.9%), and Conners Teacher Rating Scale (24%).
- Clinical examination identified ADHD in only 9.67% of the children.
- Discrepancies highlight the challenges in diagnosing ADHD in this population using standardized scales.
Conclusions:
- Detailed clinical examination is superior to neuropsychological tests and rating scales for diagnosing ADHD in pediatric liver transplant recipients.
- Relying solely on standardized tests may lead to overdiagnosis or misdiagnosis.
- Clinical judgment is paramount for accurate ADHD diagnosis in children with a history of liver transplantation.
Objectives:
This prospective cohort study aimed to determine the prevalence of attention-deficit hyperactivity disorder and to reveal how the diagnosis of attention-deficit/hyperactivity disorder can be made most accurately in children with liver transplant.
Materials And Methods:
We studied a group of 62 children from 6 and 18 years old who underwent liver transplant at least 1 year previous to our study and who were followed up in the Department of Pediatric Gastroenterology. A child and adolescent psychiatrist evaluated all liver transplant patients for attention- deficit hyperactivity disorder based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The Kiddie Schedule for Affective Disorders and Schizophrenia (in Turkish) was applied to the children. The Kiddie Schedule and the Conners Parent Rating Scale were applied to the children's parents. The Conners Teacher Rating Scale was applied to the children's teachers.
Results:
The frequency of attention-deficit hyperactivity disorder in the sample was found to be 24.5% according to Kiddie Schedule, 45.9% according to the Conners Parent Rating Scale, and 24% according to the Conners Teacher Rating Scale. However, clinical examination showed that 9.67% of the children had attention-deficit hyperactivity disorder.
Conclusions:
We concluded that detailed clinical examination is more important than neuropsychological tests and scales when diagnosing attention-deficit hyperactivity disorder in pediatric liver transplant recipients.
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