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Autism and attention-deficit/hyperactivity disorder in children with Dravet syndrome: A population-based study
Colin Reilly1,2, Björn Bjurulf1,2, Tove Hallböök1,2
1Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Insights
Children with Dravet syndrome frequently exhibit autism and attention-deficit/hyperactivity disorder (ADHD). Screening for these conditions is recommended due to their high prevalence and associated factors like intellectual disability.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
- Child Psychiatry
Background:
- Dravet syndrome is a severe form of epilepsy in children.
- Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are common co-occurring conditions in neurodevelopmental disorders.
- Understanding the prevalence and associated factors of ASD and ADHD in Dravet syndrome is crucial for comprehensive care.
Purpose of the Study:
- To determine the population-based prevalence of autism and ADHD in children diagnosed with Dravet syndrome.
- To identify factors associated with the presence and severity of autism and ADHD symptoms in this cohort.
- To inform clinical practice regarding screening and management.
Main Methods:
- A cohort of 41 children with Dravet syndrome in Sweden (born 2000-2018) was assessed.
- Diagnostic criteria from the DSM-5 were used for autism and ADHD.
- Regression analyses were employed to investigate associated factors.
Main Results:
- 25 out of 41 children met DSM-5 criteria for Autism Spectrum Disorder (ASD).
- 12 out of 37 children met DSM-5 criteria for Attention-Deficit/Hyperactivity Disorder (ADHD).
- Severe intellectual disability correlated with increased autistic features and ASD diagnosis. Younger age was linked to more ADHD features, predominantly inattentive type.
Conclusions:
- Autism and ADHD are highly prevalent in children with Dravet syndrome.
- Screening for both ASD and ADHD should be a standard part of clinical care for children with Dravet syndrome.
- The findings highlight the need for integrated management strategies.
Aim:
To identify on a population basis the prevalence of autism and attention-deficit/hyperactivity disorder (ADHD) in children with Dravet syndrome and factors associated with symptoms of autism and ADHD.
Method:
Forty-one of 48 children with Dravet syndrome living in Sweden, born between 1st January 2000 and 31st December 2018 underwent assessment including measures of autism and ADHD. Diagnoses of autism and ADHD were made with respect to DSM-5 criteria. Factors associated with features of autism and ADHD were analysed via regression.
Results:
Twenty-five of the 41 children fulfilled DSM-5 criteria for autism spectrum disorder and 12 of 37 children considered for an ADHD diagnosis fulfilled DSM-5 criteria for ADHD. Severe intellectual disability was significantly associated with a greater degree of autistic features (p < 0.001) and a DSM-5 diagnosis of autism spectrum disorder (p = 0.029). Younger children had significantly more features of ADHD (p = 0.004) and features of inattention were significantly more common than features of hyperactivity/impulsivity (p < 0.001).
Interpretation:
Children with Dravet syndrome often have significant features of autism and ADHD, primarily inattentive type. Screening for autism and ADHD should be routine in children with Dravet syndrome.
What This Paper Adds:
In total, 25 of 41 assessed children with Dravet syndrome fulfilled DSM-5 criteria for autism. Twelve of 37 assessed children with Dravet Syndrome met DSM-5 criteria for attention-deficit/hyperactivity disorder (ADHD). Severe intellectual disability was significantly associated with a greater degree of autism spectrum disorder features. Younger children had significantly more features of ADHD.
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