A Nomogram for Predicting ADHD and ASD in Child and Adolescent Mental Health Services (CAMHS)
Abstract
:1. Introduction
2. Methods
2.1. Participants
2.2. Outcome Variables
2.3. Potential Predictors
2.4. Statistical Analyses
2.5. Graphical Outcomes: Nomograms
3. Results
4. Discussion
4.1. Predictors of ADHD
4.2. Predictors of ADHD, Hyperactive/Combined Subtype
4.3. Predictors of ASD
4.4. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Operationalization | Categories | Frequencies or Mean (sd) * |
---|---|---|---|
Age | How old (in years) is the patient? | Continuous variable | 11.1 (3.9) |
Gender | What is the gender of the patient? | Male (0) or Female (1) | Male = 593 Female = 276 |
Adopted | Was the child adopted? | Yes (1) or No (0) | No = 798 Yes = 52 |
Family (first grade) psychiatric antecedents | Does the patient have any first-grade relative formally diagnosed with any mental disorder? | Yes (1) or No (0) | No = 332 Yes = 471 |
Risky pregnancy | Was the patient’s gestation a risky pregnancy? | Yes (1) or No (0) | No = 608 Yes = 236 |
Use of toxic substances by the mother during pregnancy | Did the patient’s mother take any toxic substances during pregnancy? | Yes (1) or No (0) | No = 783 Yes = 18 |
Stress/depression during pregnancy | Did the patient’s mother suffer stress or depression during pregnancy? | Yes (1) or No (0) | No = 644 Yes = 192 |
Preeclampsia during pregnancy | Did the patient’s mother suffer preeclampsia during pregnancy? | Yes (1) or No (0) | No = 805 Yes = 23 |
Comorbidity in Axis I (Clinical Disorders) | Does the patient have a second Axis I diagnosis? | Yes (1) or No (0) | No = 245 Yes = 616 |
Diagnosis in Axis III | Does the patient have a diagnosis of a disorder included in Axis III (general medical condition)? | No = 59 Yes = 809 | |
Atopy | Did the patient suffer atopy? | Yes (1) or No (0) | No = 485 Yes = 371 |
History of bone fractures or repetitive injuries evaluated or not at the ER? | Has the patient ever suffered a bone fracture? Has the patient had repetitive injuries evaluated at the ER? | Yes (1) or No (0) | No = 469 Yes = 378 |
Diagnosis in Axis IV | Does the patient have a diagnosis of a disorder included in Axis IV (psychosocial problems)? | Yes (1) or No (0) | No = 187 Yes = 661 |
Disability | Does the patient suffer any disability? | Yes (1) or No (0) | No = 717 Yes = 140 |
Urine control (day and evening) | Does the patient control his/her urine? | Yes (1) or No (0) | No = 112 Yes = 713 |
Fecal control | Does the patient control his/her feces? | Yes (1) or No (0) | No = 162 Yes = 761 |
Started walking | Age (in months) at which the patient started walking | Continuous | 15.76 (8.35) |
Special education needs | Does the patient have any special education needs? | Yes (1) or No (0) | No = 716 Yes = 108 |
Genetics | Any confirmed genetic disease? | Yes (1) or No (0) | No = 801 Yes = 43 |
Physically active | Does the patient exercise regularly? | Yes (1) or No (0) | No = 259 Yes = 573 |
Admitted to the psychiatric acute inpatient unit? | Has the patient ever been admitted to the psychiatric acute inpatient unit? | Yes (1) or No (0) | No = 794 Yes = 50 |
Admitted (hospitalization) in pediatric services | Has the patient ever been hospitalized in pediatric services? | Yes (1) or No (0) | No = 709 Yes = 130 |
Medical treatment | Is the patient taking any medication regarding a general medical condition? | Yes (1) or No (0) | No = 399 Yes = 461 |
Axis V score | Which is the global assessment scale? (0–100) | Continuous | 68.98 (12.16) |
Total | ADHD (n = 599) | No ADHD (n = 246) | p | Hyperactive/Combined (n = 414) | Inattentive (n = 185) | p | ASD (n = 84) | No ASD (n = 84) | p | |
---|---|---|---|---|---|---|---|---|---|---|
Age | 11.1 (3.9) | 11.6 (3.5) 3–18 | 9.8 (4.6) 1.5–22 | <0.001 | 11.1 (3.5) | 12.7 (3.0) | <0.001 | 8.6 (4.4) | 11.3 (3.7) | <0.001 |
Sex (% Female) | 31.7% | 29.9% | 35.4% | 0.139 | 29.6% | 39.5% | <0.001 | 11.9% | 33.6% | <0.001 |
Nationality (% Spanish) | 84.9% | 85.0% | 84.5% | 0.9375 | 86.4% | 84.4% | 0.599 | 76.2% | 85.8% | 0.029 |
Model | Factor | OR (95% CI) | VIF | Condition Number |
---|---|---|---|---|
ADHD (n = 632) | Constant | 11.68 | ||
Risky pregnancy (No = 0, Yes = 1) | 1.85 (1.14, 3.00) | 1.063 | ||
Age of first words (in months) | 0.86 (0.73, 1.02) | 1.125 | ||
Urine control (No = 0, Yes = 1) | 0.32 (0.13, 0.88) | 1.630 | ||
Fecal control (No = 0, Yes = 1) | 7.14 (2.56, 19.23) | 1.623 | ||
Special educational needs (No = 0, Yes = 1) | 0.29 (0.13, 0.63) | 1.445 | ||
Disability (No = 0, Yes = 1) | 0.34 (0.18, 0.67) | 1.425 | ||
Physically active (No = 0, Yes = 1) | 1.63 (1.05, 2.52) | 1.052 | ||
History of bone fractures (No = 0, Yes = 1) | 2.20 (1.44, 3.37) | 1.036 | ||
Medical treatment (No = 0, Yes = 1) | 3.33 (2.17, 5.05) | 1.065 | ||
Pediatric admission (No = 0, Yes = 1) | 0.44 (0.26, 0.74) | 1.023 | ||
Psychiatric admission (No = 0, Yes = 1) | 0.29 (0.12, 0.70) | 1.023 | ||
Comorbidity with Axis I diagnose (No = 0, Yes = 1) | 3.70 (2.32, 5.54) | 1.070 | ||
ADHD subtype: Hyperactive/Combined (n = 551) | Constant | 2.79 | ||
History of bone fractures (No = 0, Yes = 1) | 1.66 (1.14, 2.54) | 1.020 | ||
Psychiatric admission (No = 0, Yes = 1) | 6.43 (1.36, 28.31) | 1.007 | ||
Sex (Male = 0, Female = 1) | 0.60 (0.41, 0.89) | 1.058 | ||
Age (in years) | 0.86 (0.81, 0.91) | 2.896 * | ||
ASD (n = 634) | Constant | 3.02 | ||
Special educational needs (No = 0, Yes = 1) | 2.78 (1.25, 6.20) | 1.685 | ||
History of bone fractures (No = 0, Yes = 1) | 0.47 (0.24, 0.93) | 1.013 | ||
Disability (No = 0, Yes = 1) | 8.90 (3.91, 20.28) | 1.723 | ||
Sex (Male = 0, Female = 1) | 0.21 (0.09, 0.48) | 1.026 | ||
Diagnostic in Axis V (No = 0, Yes = 1) | 0.66 (0.50, 0.89) | 1.751 |
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Blasco-Fontecilla, H.; Li, C.; Vizcaino, M.; Fernández-Fernández, R.; Royuela, A.; Bella-Fernández, M. A Nomogram for Predicting ADHD and ASD in Child and Adolescent Mental Health Services (CAMHS). J. Clin. Med. 2024, 13, 2397. https://doi.org/10.3390/jcm13082397
Blasco-Fontecilla H, Li C, Vizcaino M, Fernández-Fernández R, Royuela A, Bella-Fernández M. A Nomogram for Predicting ADHD and ASD in Child and Adolescent Mental Health Services (CAMHS). Journal of Clinical Medicine. 2024; 13(8):2397. https://doi.org/10.3390/jcm13082397
Chicago/Turabian StyleBlasco-Fontecilla, Hilario, Chao Li, Miguel Vizcaino, Roberto Fernández-Fernández, Ana Royuela, and Marcos Bella-Fernández. 2024. "A Nomogram for Predicting ADHD and ASD in Child and Adolescent Mental Health Services (CAMHS)" Journal of Clinical Medicine 13, no. 8: 2397. https://doi.org/10.3390/jcm13082397