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2014, Número 6

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Salud Mental 2014; 37 (6)


Adversidad psicosocial, psicopatología y funcionamiento en hermanos adolescentes en alto riesgo (HAR) con y sin trastorno por déficit de atención con hiperactividad (TDAH)

Palacios-Cruz L, Arias-Caballero A, Ulloa RE, González-Reyna N, Mayer-Villa P, Feria M, Sosa L, de la Peña FR, Cabrera-Lagunes A, Fragoso A, Sepúlveda A, Cruz CS, Clark PP, Pérez JC, Lara-Muñoz MC, Benjet C

Idioma: Español
Referencias bibliográficas: 56
Paginas: 467-476
Archivo PDF: 341.77 Kb.


RESUMEN

Introducción. El trastorno por déficit de atención con hiperactividad (TDAH) es un trastorno del neurodesarrollo altamente heredable. La determinación de las características clínicas, los factores de adversidad y http://webmail.medigraphic.com/index.php?url=http%3A%2F%2Fwebmail.medigraphic.com%2Fel nivel de funcionamiento en hermanos de probandos con TDAH, denominados en alto riesgo (HAR), podría ayudar a establecer el riesgo al cual están sometidos.
Objetivo. Determinar la frecuencia de TDAH y otros trastornos psiquiátricos en HAR. Como objetivos secundarios, establecer los factores de adversidad psicosocial que predicen el TDAH en HAR y determinar la magnitud del efecto sobre el funcionamiento y otros trastornos psiquiátricos cuando los hermanos tienen TDAH (HAR TDAH +) comparados con quienes no lo tienen (HAR TDAH -).
Material y método. Este estudio multicéntrico es descriptivo, transversal y analítico. La muestra (n=84) se conformó por hermanos adolescentes de probandos diagnosticados con TDAH que compartían a ambos padres.
Resultados. El 45.2% (n=38) tuvo TDAH. El 17.9% (n=15) no presentó trastorno psiquiátrico alguno. Ser HAR TDAH+ incrementó al menos cuatro veces más la probabilidad de presentar trastorno negativista desafiante (RM=4.3; IC 95% 1.3-14.8), dato que mantuvo significancia al ajustarse por sexo, edad y número de adversidades (RM=3 IC 95% 1.8–10.9). Ser HAR TDAH+ incrementó casi cinco veces la probabilidad de presentar disfunción académica (RM=4.84 IC 95% 1.41-16.63). El promedio general de adversidades fue 3.3 (DE=1.4). Encontramos psicopatología en ambos padres en el 51.2% de la muestra (ES=0.055). La disfunción familiar grave incrementó 2.5 veces la probabilidad de presentar TDAH en los HAR (IC 95% 1.06–6.25). Al comparar los grupos con tres o más adversidades psicosociales, no existieron diferencias significativas (81.6% vs. 65.2%; p=0.14).
Conclusiones. El estudio clínico de los HAR para TDAH es necesario debido a las distintas implicaciones que tiene a nivel de la prevención, la atención oportuna y la mejoría del pronóstico de estos sujetos.


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