Mahajnah, M., R. Sharkia, N. Shorbaji, R. Terkel-Dawer, and N. Zelnik. “P173 – 2561: The Clinical Profile of ADHD in Israel – Impact of Ethnic and Social Diversities.” European Journal of Paediatric Neurology 19, sup. 1 (2015): S142 ff.
The diagnosis of ADHD relies mostly on clinical observation and employment of standard questionnaires and checklist batteries which are highly susceptible to human factors. In this study we searched for differences in the clinical profile of children with ADHD in both the Arab and Jewish sectors in Israel which might be influenced by cultural and social background.
Data of children aged 7–17 years diagnosed with ADHD between 2010 and 2013 in two ADHD clinics in northern Israel was analyzed. The diagnosis of ADHD was based on clinical evaluation and fulfillment of the DSM IV criteria and aided by both the Teacher and Parent Conners Rating Scales. Children with autism and intellectual disabilities were excluded.
Out of 823 patients – 516 (62.7%) were Jewish and 307 (37.3%) were Arabs. The distributions of the ADHD subtypes were similar in both populations. Learning disabilities (LD) and psychiatric comorbidities (behavioral difficulties and anxiety) were reported more frequently in the Jewish population (49% vs. 41% for LD, 15.7% vs. 12.8% for behavioral difficulties and 27.0% vs. 1.0% for anxiety p<0.05). Patients from the Jewish sector were primarily treated with long-acting methylphenidate formulations while patients from the Arab sector were treated primarily with short acting methylphenidate (p<0.05). The most commonly reported adverse effects were anorexia, headache, insomnia and rebound effect and were more frequently reported in the Jewish population (42.0% vs. 18.0% P<0.05).
This study demonstrates that while the biological nature of ADHD and its subtypes are similar in these two populations, learning disabilities, psychiatric co morbidities, employment of long-acting MPH formulations and complaints of side-effects were more prevalent in patients from the Jewish sectors. We presume that these differences are related to cultural and socioeconomic factors and the physician should take them into consideration when treating patients with ADHD.