الفهرس 
Attention Deficit Hyperactivity DisorderOnly 14 pages are availabe for public view
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Abstract
Attention deficit hyperactivity disorder (ADHD) is characterized by pervasive and impairing symptoms of inattention, hyperactivity and impulsivity according to DSM-V. The cause of ADHD is generally acknowledged to be multifactorial, involving both biological and environmental influence.The main aims of the current study were to investigate the percentage of allergic conditions among clinically diagnosed children with ADHD, to detect the most common allergens in ADHD children with concurrent allergic disorders, and to investigate the effect of allergy on symptom patterns, severity and its association with demographic variables in ADHD children.Accordingly, 100 children (83 males and 17 females) with the diagnosis of ADHD, approving to participate in the study, with age ranges from 6 to 12 years and IQ levels above 90 with no co-morbid neuropsychiatric disorder or chronic medial disorder were included in the study. All cases were recruited from the attendants of the outpatient clinic of the child psychiatry - The institute of psychiatry –Ain-Shams university hospital. The sample divided into 2 groups; patient group and control group. The patient group consists of diagnosed cases with ADHD and coexisting allergies, The control group consists of ADHD who test negative for allergies. Children are matched for age and sex to the patient group. Both cases and controls were assessed using Mini International Neuropsychiatric Interview for Children for diagnosis of ADHD and exclusion of other psychiatric comorbidities. Also their IQ was assessed using Wechsler Intelligence Scale for Children, the Conners’ parent rating scale-revised for assessment of the severity of their symptoms. Assessment for allergy – was done for both patients and controls using skin prick test and serum total IGE. Regarding the demographic and the clinical characteristics of the sample, the results of our study showed that males represented 83% and females represented 17% of ADHD children in a ratio of nearly 4.8:1, with mean age of 8.54 years. none of the ADHD children had organicity by intelligence quotient (IQ) (100%). There was no statistically significant difference between them regarding gender, age, religion, and residency. The initial assessment of the ADHD children with Conners’ parent rating scale showed that they had significant problems on the oppositional, cognitive problem, inattentive, lability, hyperactivity, and hyperactive-impulsive. while the assessment using Mini-Kid revealed comorbid subthreshold psychiatric disorders (anxiety and oppositional defiant). Regarding allergy assessment using skin prick test 16% of ADHD children had positive SPT. the most common allergens causing sensitization, we found that dust (hay dust, house dust, mixed dust) comprised the commonest allergen, followed by pollens, and wheat then comes yeast. Sensitization to mixed allergens comprises the vast majority of cases, followed by aeroallergen then comes food allergen. Regarding allergy assessment using serum total IGE, 45% of ADHD children had positive total IGE. On examining the impact of allergy on ADHD children, there were a statistically significant difference between co-existence of allergy in ADHD children with severity of symptoms (oppositional, cognitive problem, inattentive, lability, hyperactivity, hyperactive-impulsive), type of ADHD (combined, hyperactive-impulsive, inattentive), and the presence of co-morbid sub-threshold symptoms (anxiety, oppositional defiant).On examining the impact of age of onset of ADHD on ADHD children, there were a statistically significant difference between age of onset of ADHD and positive family history of allergy, severity, and type of ADHD. On examining the impact of type of ADHD on ADHD children, there were a statistically significant difference between type of ADHD and each of the following; family history of allergy, allergic ADHD children, positive skin prick test and total IGE.On examining the impact of severity of ADHD symptoms on ADHD children, there were a statistically significant difference between severity of all ADHD symptoms (oppositional, cognitive problem, inattentive, lability, hyperactivity, hyperactive-impulsive) with each of the following; type of ADHD, allergic ADHD children, positive skin prick test, and total IGE levels.On examining the impact of co-morbid sub-threshold disorders on ADHD children, there were a statistically significant difference between co-morbid sub-threshold disorders and with each of the following; skin prick test, type of allergens (collective), total IGE, Allergic ADHD children, food additives, and family history of allergy.from the above mentioned; we can conclude that children with ADHD had an increased prevalence of allergic diseases. Allergic ADHD children, had more severe ADHD symptoms (oppositional, cognitive problem, inattentive, lability, hyperactivity, hyperactive-impulsive), and more co-morbid sub-threshold disorders (anxiety, oppositional defiant).Finally we recommend that determining and avoiding triggers (aeroallergens, food allergens, and food additives) will reduce the predisposition to ADHD, and consequently reduce the use of medication. We also recommend more understanding of the biologic mechanisms explaining the association of allergic disease and psychological development in children would therefore be of great public health significance, as targeted preventive measures for children with allergic disease may help to decrease the burden of ADHD in children and adolescents.