Cuestionario para Escolares y Adolescentes ...

1 Cuestionario para Escolares y Adolescentes Latinoamericanos con TDAHS55 Vol. 32, Supl. 1, 2009 Salud Mental 2009;32:S55-S62 Cuestionario para Escolares y AdolescentesLatinoamericanos con Trastorno por D ficitde Atenci n con Hiperactividad (CEAL-TDAH).Construcci n, descripci n del instrumento y datossociodemogr ficos y cl nicos de la muestraComit Internacional para el Desarrollo y Estudio del Cuestionario para Escolares yAdolescentes Latinoamericanos con Trastorno por D ficit de Atenci n con Hiperactividad (CEAL-TDAH)*SUMMARYI ntroductionAttention Deficit Hyperactivity Disorder (ADHD) is one of the mostcommon neuropsychiatric disorders.

2 The current prevalence of thedisorder in pediatric population has been estimated around ADHD is a lifelong illness with different manifestations duringchildhood, adolescence, and adulthood. Untreated ADHD generatesa great dysfunction in several domains, including school and workperformance, family, and peer relationships. Because of the highprevalence and dysfunction linked to the disorder, there is a need touse severity checklists and screening instruments. Some of thedimensional scales used to evaluate ADHD are: The Child BehaviorChecklist and the Brief Psychiatry Rating Scale for Children andAdolescents, both translated and validated in Spanish.

3 The severity scalesmost commonly used are the Conners Scales and some others like theTeachers Rating Scale from the Hospital Psiquiatrico Infantil in Mexicoand several checklists derived from the 18 symptoms of the DSM,including the Argentine SNAP-IV version. Some screening instrumentshad been used in epidemiological searching of ADHD design an screening instrument for ADHD suitable for theevaluation of Latin American school age children and adolescents,and describe the sociodemographic and clinical characteristics ofthe sample used for its construction of the instrument was carried out by an expertpanel, integrated with psychiatrists, child and adolescentpsychiatrists, child-neurologists, and neuropsychologists.

4 During thefirst Latin American Consensus for ADHD held in Mexico, City inJune 17-18 of 2007. All of them were certified by the respectiveboards in each country. The items from the instrument weredeveloped taking in to account the criteria used for ADHD in theDiagnostic and Statistical Manual for Mental Disorders, IV edition(DSM-IV) of the American Psychiatric Association and to beresponded by the father or the mother in a Likert-type scale. Themain criteria for the detection of inattention, hyperactivity, andimpulsivity were included, as well as a poor psychomotorcoordination tem. The instrument was translated into pilot study was run at three countries with 10 subjects in eachone.

5 The sample was integrated with epidemiological and clinicalevaluated subjects; the clinical sample was also diagnosed for othermajor psychopathologies according to the final instrument was composed by 28 items: 15 for inattention,seven for hyperactivity and four for impulsivity. The severity of each tem could be evaluated from 0 to 3 and the total maximum scorewas 84 points. We received 985 completed questionnaires from ninecountries from North, Central and South America. The sample wasintegrated with 403 ( ) and 582 ( ) of epidemiological and* Miembros del Comit :Coordinadora: Rosa Elena Ulloa Flores, Psiquiatra, M de la Pe a Olvera, Psiquiatra de Ni os y de Adolescentes , M xico; Lino Palacios Cruz, Psiquiatra de Adolescentes , M xico; Silvia Ortiz Le n,Psiquiatra de Ni os y de Adolescentes , M xico; Juan David Palacio Ortiz, Psiquiatra de Ni os y de Adolescentes , Colombia; Eugenio Horacio Grevet,Psiquiatra, Brasil; Juan Carlos Resendiz Aparicio, Neuropediatra, M xico; Alejandro Olmos L pez, Neuropediatra, M xico.

6 Ana Valdez P rez, Psiquiatrade Ni os y de Adolescentes , Chile; Ana Bertha Meza P rez, Psiquiatra de Ni os y de Adolescentes , M xico; Cecilia Margarita Montiel Nava, Neuropsic -loga, Venezuela; Edith Padr n S lomon, Psiquiatra de Ni os y de Adolescentes , M xico; Elizabeth Landeros, Psiquiatra de Ni os y de Adolescentes ,M xico; Flora de la Barra Mc Donald, Psiquiatra de Ni os y de Adolescentes , Chile; Carolina Remedi, Psiquiatra de Ni os y de Adolescentes , Argentina;Foad Hassan, Neur logo, Nicaragua; Francisco Ram rez, Psiquiatra, Honduras; Jos Ovidio Cornelio Nieto, Neuropediatra, M xico; Jos Visoso Franco,Neuropediatra, M xico; Julia Ribbon Conde, Neur loga, M xico; Leopoldo Rivera Casta o, Neuropediatra, M xico; Wellington Borges Leite, Neur logo,Brasil; Norberto Abel Luna L pez, Neuropediatra, M xico; Norma Olga Taddey, Psiquiatra de Ni os y de Adolescentes , Argentina; Octavio Ibarra Le n,Psiquiatra, M xico; Orlando Villegas, Neuropsic logo, Estados Unidos de Am rica; Reyna Dur n Mart nez, Neur loga, Honduras; Sandra Luz Guill nM ndez, Neuropediatra, M xico.

7 Diana Molina Valdespino, Psiquiatra de Ni os y de Adolescentes , M xico; Soledad Mu oz, Psiquiatra de Ni os y deAdolescentes, : Dr. Francisco de la Pe a Olvera. Instituto Nacional de Psiquiatr a RFM. Calz. M xico-Xochimilco 101, San Lorenzo Huipulco, Tlalpan,14370, M xico, D. F. primera versi n: 15 de junio de 2009. Segunda versi n: 28 de junio de 2009. Aceptado 30 de junio de CEAL-TDAHS56 Vol. 32, Supl. 1, 2009 INTRODUCCI NEl trastorno por d ficit de atenci n con hiperactividad(TDAH) es uno de los principales trastornos neuropsiqui -tricos de inicio en la infancia. Se caracteriza por una tr adasintomatol gica.

8 Capacidad de atenci n disminuida,hiperactividad e impulsividad, todos los cuales se presen-tan de manera inapropiada para el desarrollo y generandeterioro en el funcionamiento La prevalencia delTDAH es de en todo el mundo de acuerdo con losm s recientes estudios metaanal La frecuencia re-portada en los diferentes estudios internacionales no pare-ce depender del grado de desarrollo de los pa Estepadecimiento persiste hacia la vida adulta en 40% de loscasos e implica un alto costo para el paciente, su familia yla sociedad. Los ni os con TDAH no tratado solicitan dosveces m s intervenciones m dicas que los ni os sin l debi-do a que tienen mayor riesgo de presentar accidentes y heri-das, adem s de comorbilidad psiqui trica, que aumenta lagravedad del TDAH y los costos del ,5 Este tras-torno conduce a una disfunci n psicosocial en las diferentesetapas del ciclo vital.

9 As , el paciente no tratado manifiestaun pobre funcionamiento acad mico y/o laboral, abandonala escuela y tiene trabajos con sueldos m s bajos. La relaci ncon sus familiares se deteriora tambi n, adem s de que lospacientes con patolog a persistente en la vida adulta pue-den tener entonces pocas habilidades maritales y alta prevalencia y las consecuencias del TDAH po-nen de manifiesto la necesidad de realizar programas dedetecci n temprana que utilicen instrumentos estandariza-dos. Los instrumentos de tamizaje se aplican a la poblaci ngeneral y se alan a los posibles casos para su remisi n a losservicios de salud mental.

10 para la detecci n de los casos,puede recurrirse al uso de instrumentos como las escalas degravedad y de tamizaje. Recientemente se public una revi-si n detallada de entrevistas diagn sticas, escalas dimensio-nales y de gravedad para el TDAH que puede ser A n as , a continuaci n se detallan algunas escalasdimensionales, de severidad de la psicopatolog a y detamizaje, utilizadas para medir los s ntomas del sources, respectively; 644 (65%) were male and the meanage of those evaluated was ( ) years. Most questionnaires(79%) were responded by the mothers. In the clinical sample, 487subjects were diagnosed with ADHD and with a combinedsubtype.