SAN ANTONIO – Many children with attention-deficit/hyperactivity disorder or oppositional defiant disorder no longer meet diagnostic criteria for these psychopathologies 6 months after they undergo adenotonsillectomy for standard indications, a large prospective patient series suggests.
The most striking finding in this study of 140 children aged 3-12 years who underwent adenotonsillectomy involved the 81% reduction in the prevalence of oppositional defiant disorder (ODD) at 6 months post surgery, Dr. James E. Dillon reported.
Baseline rates of ADHD and ODD were high, in accord with earlier studies of children scheduled for adenotonsillectomy: In all, 54 children (39%) met DSM-IV criteria for some form of ADHD, whereas 26 (19%) met criteria for ODD.
At 6 months after adenotonsillectomy, however, only 32 patients (23%) still met criteria for some form of ADHD. The rest no longer did. Particularly impressive was the reduction in ADHD of the combined type: Overall, 30 kids (21%) met the diagnostic criteria for this disorder at baseline, compared with 18 (13%) at follow-up, said Dr. Dillon, a child and adolescent psychiatrist at the University of Michigan, Ann Arbor.
Meanwhile, the prevalence of ODD dropped from 26 children at baseline to just 5 (3.6%) at 6 months post surgery, he said.
Participants were recruited from various otolaryngology practices in Michigan. Before being approached for the study, all of the children were already scheduled for adenotonsillectomy. The subjects' mean age was 7.2 years, 55% were boys, and 78% of the children were white.
The participants included 35 preschoolers. Nineteen preschoolers (54%) had a behavior disorder at baseline, compared with 12 (34%) at follow-up. In all, 9 preschoolers met criteria for ODD at enrollment, compared with just 2 at follow-up, and 19 had any form of ADHD at entry, as did 12 at follow-up.
Disclosures: Dr. Dillon reported no financial conflicts with regard to the study.