Evaluation of child patients with attention deficit hyperactivity disorder according to their specific sub-TYPES, according to the external attention and interention problems, difference in terms of chronotype

Evaluating Whether Externalizing and Internalizing Problems Accompanying According to Specific Subtypes of Child Cases with Attention Deficit Hyperactivity Disorder Differ in Chronotype Objective: There is a lot of literature on the relationship between Attention Deficit Hyperactivity Disorder (ADHD) symptoms and chronotype subtypes. A relationship between chronotype and ADHD has been found, but studies on the differences between chronotype and specific ADHD subtypes are limited. The aim of our study is to examine whether ADHD cases followed with the diagnosis of ADHD and using drug therapy differ in terms of chronotype according to their subtypes and accompanying externalizing and internalizing problems. Materials and Methods: The study was planned as cross-sectional and prospective. Our study was carried out in Bolu Abant İzzet Baysal University Medical Faculty Hospital Child and Adolescent Psychiatry Outpatient Clinics between January 2021 and July 2021. Inclusion criteria for the study; According to DSM- 5 diagnostic criteria, it was determined as having a diagnosis of ADHD, being followed up and treated with a diagnosis of ADHD, using medication for at least 2 months for the diagnosis of ADHD, and being between the ages of 9 and 12 years. In order to determine the psychiatric disorders of the children included in the study, Kiddie- Affective Disorders and Schizophrenia Interview Inventory for School-Age Children- Now and Lifetime Versions were applied; The Child Anxiety and Depression Scale Revised Questionnaire was applied to identify internalizing problems in children; Childhood Chronotype Questionnaire (Parent Form) for chronotype subtype assessment; The Atilla Turgay Screening and Evaluation Scale based on DSM- IV for Disruptive Behavior Disorders was used to evaluate attention deficit and hyperactivity symptoms and disruptive behavior disorders. A sociodemographic data form was used to evaluate sociodemographic characteristics, living in an urban/rural area, presence of a night light and technological equipment in the room where he slept, income level of the family, and peer relations. Results: 121 cases were included in our study within the specified time period. It was found that most of the cases were male. The mean age of the cases was determined as 10.21 ± 1.24 years. Considering the birth dates of the cases, it was seen that the most common season of birth was spring while there was no significant difference between ADHD subtypes (p= 0.477). 46.3% of the cases had at least one comorbidity; It has been found that the most common comorbidities were disruptive behavior disorders. When ADHD subtypes were compared, the highest rate of comorbidity was seen in the combined subtype (p= 0.035). When the whole sample was evaluated, it was found that the intermediate type was the most common among the chronotype subtypes. There was no significant difference between ADHD subtypes in terms of chronotype (p= 0.288). Considering the ADHD subtypes of the cases, it was seen that 29.8% of them were attention deficit dominant type, 16.5% hyperactivity/ impulsivity dominant type, and 53.7% combined type. When the presence of sleep problems in infancy was examined, it was observed that the attention deficit-dominant type had most frequent reports of sleep problems in infancy (p= 0.051). In the whole sample group, a positive and significant correlation was found between the attention deficit, hyperactivity, oppositional defiant disorder total score of the DSM-IV-Based Screening and Evaluation Scale for Disruptive Behavior Disorders and the total score of the Childhood Chronotype Questionnaire (p<0.05 for each). It was found that the total attention deficit score of the DSM-IV-Based Screening and Evaluation Scale for Disruptive Behavior Disorders predicted the total score of the Childhood Chronotype Questionnaire (p= 0.015). Conclusion: In our study, it was found that the total score of the childhood chronotype questionnaire was predicted by the attention deficit total score of the DSM-IV-Based Screening and Evaluation Scale for Destructive Conduct Disorders. It is thought that there is a need for studies with larger samples and age range of children and adolescents.