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¿Por qué no se mejoran los niños con trastornos por déficit de atención con hiperactividad?
¿Why don´t inprove children with attention-deficit and hyperactivity disorder?
Palabras clave:
trastorno deficitario de atención con hiperactividad, psiquiatría infantil, estudios de seguimiento, prescripción de medicamentos (es)attention deficit disorder with hyperactivity, child psychiatry, follow-up studies, prescriptions, drug (en)
Introducción. Durante el año 2004, en consulta externa e interconsultas del servicio de psiquiatría infantil, se hicieron 1454 valoraciones, correspondientes a 592 pacientes. De éstas, 536 fueron por trastorno deficitario de atención con hiperactividad (TDAH), correspondientes a 240 pacientes. Se preguntó al paciente y familiares si la condición que motivó la consulta se encontraba mejor, peor o igual. Según el registro en el sistema, 76% estaban igual o peor; 23% mejor y 1% no contestó. Se hizo el estudio para determinar qué sucedió con aquellos cuyos registros estadísticos no mostraban mejoría.
Objetivo. Caracterizar los pacientes que asistieron a la consulta de psiquiatría infantil en quienes se hizo diagnóstico de TDAH y no reportaron mejoría clínica.
Material y métodos. Revisión de historias clínicas y entrevista personal con pacientes que consultaron al servicio de psiquiatría del Hospital Pediátrico de la Misericordia durante 2004 en quienes se hizo diagnóstico de TDAH y no reportaron mejoría clínica.
Resultados. En 237 pacientes con sospecha de TDAH se confirmó el diagnóstico en 157 (66.2%); se inició tratamiento a 114 (48.1%). Tras seguimiento, se encontró que 94 mejoraron y 20 lo abandonaron; tres expusieron sus motivos.
Conclusiones. Como informa la literatura internacional, se logró mejoría clínica en 82.45%. En quienes no mejoran se encuentran múltiples razones para explicar el abandono del tratamiento.
Background. During the year 2004, 1454 evaluations, corresponding to 592 patients, were made in outward and inter consultation. Out of these evaluations, 536 were because of ADD, corresponding to 240 patients. We asked the patients and their families whether, the children's condition that brought them to consultation had improved, was worse or the same. According to the registration system, 76% were the same or worse, 23% were better and 1% did not answer. We made a study in order to determine what had happened to the patients whose statistic registration showed no improvement. Objective. Characterizing the patients who came to consultation at the Children's Psychiatric consultation in the Hospital de la Misericordia during 2004 and who were diagnosed as ADD not reporting clinical improvement.
Material and methods. Patients who came to consultation at the Pediatric Psychiatric service of the Hospital de la Misericordia during the year 2004, who were diagnosed as ADD and did not report clinical improvement.
Results. In 237 patients suspicious of having ADD was confirmed in 157 patients (66%). Treatment was begun in 114 (48%). In the follow up studies, it was found that 94 improved, 20 abandoned the treatment; of these, three let give us their motivation.
Conclusions. We found mistakes in the patients' registration, specifically in the improvement indicator, and that frequently it was not possible to confirm diagnosis, nor initiate treatments, because the patients did not come back after the first consultation or abandoned the treatment.
As reported by international literature, there was 82.45% clinical improvement. Multiple reasons were found to explain abandonment of the treatment.
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Derechos de autor 2005 Revista de la Facultad de Medicina
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
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