Prevalence and Associated Factors of Attention Deficit Hyperactivity Disorder (ADHD) in a Rural Community, Central Thailand: A Mixed Methods Study

BACKGROUND- Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common behavioral problems among children around the world including Thailand. The disease affects their life, parents and community when left untreated. Most information concerning ADHD in Thailand derives from hospital based studies. The present study aimed to determine the prevalence and associated factors of ADHD in a remote rural community.METHODS- A total of 495 primary school children were screened using the SNAP-IV. Positive screening cases were then diagnosed by pediatric psychiatrists according to the DSM-V criteria. Standardized questionnaires were used to collect demographic data and associated factors. A qualitative study using focus group discussions and indepth interviews was conducted to determine knowledge and perceptions regarding ADHD among teachers and main guardians.RESULTS- The prevalence of ADHD among children was 2.2%. Univariate and multivariate analysis showed that children with ADHD were associated with both familial and individual factors including being repeatedly inattentive or hyperactive in class, suspended from school, and changing school, a history of bullying and main guardians were not parents. Qualitative data showed that both main guardians and teachers had inadequate knowledge and misperceptions regarding children with ADHD. The local health care system could not detect this problem so the children with ADHD were not properly treated.CONCLUSION- Our data emphasized that ADHD was a problem in this remote rural community. Screening tests and referral systems for ADHD should be provided for rural communities.