A NEW DIFFERENTIAL DIAGNOSIS OF ADHD:THE PERMEABLE PERSONALITY

Objectives: ADHD is the more common neuropsychiatric disorder diagnosis in childhood. The prevalence is uncertain, but estimates ranges between 3 and 15 worldwide. Its more common in boys than in girls (3:1). The diagnosis is clinical (DSM-IV) and response to psychoestimulants very high. However, diagnostic labels for inattentive, impulsive and hyperactive children have changed numerous times over the last decades; and the difference seeing in develop course, high heterogeneity and pharmacological responses (even responding to non conventional treatments) may be due a different personality development and not a symptoms from nervous system disorder.

Methods: 410 children with symptoms of innatention, hyperactivity and impulsivity were evaluated in a pediatric neurology department between 1999 and 2003. We examined the core symptoms, Conner's test, EEG activity and response to medication.

Results: 279 patients (68%) of the sample had criteria (DSMIV) for ADHD. Of the samples, 73% were boys, present academic achievement skills (45%) learning disabilities (18%) and normal physical examination. 20% of the rest of the population shows a problems in motor coordination (98%), delayed onset of language and speech impairments (83%), learning disabilities (92%), poor self-regulation of emotion, visospatial problems, high sensibility, high internalization of own behavior but problems with communication skills, noble, creative, and generalized hypotonia. These patients were a poor responders to psychostimulants, and had a frequent comorbility with anxiety disorders (90%).

Conclusion: The permeable personality (Barragán syndrome) is a proposal of a new differential diagnosis for ADHD patients who display differences in their development courses, need another strategies and pharmacological approaches and try to explain one of the pathways in these heterogenus group of patients.