الفهرس 
Introduction
Attention deficit hyperactivity disorder (ADHD)Only 14 pages are availabe for public view
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Abstract
ADHD is considered one of the most widespread disorders in school-age children. Generally, ADHD is characterized by persistent patterns of inattention, hyperactivity, and impulsivity ADHD in children with epilepsy prove to be very common. Both epilepsy and ADHD impair quality of life. Nevertheless, few studies evaluated the behavioural problems in children with combined epilepsy and ADHD. Aims and objectives: This study aimed to evaluate the impact of combined epilepsy and ADHD on cognitive functions, socioeconomic burden and quality of life. Also, to identify comorbid psychiatric disorders in children with combined epilepsy and ADHD. Subjects and methods: The study was carried out on a total number of 100 children, recruited from the child psychiatry clinic at Neuropsychiatric Hospital, Assiut university. Children were interviewed throughout the period from September 2018 to October 2019. The children were divided into 5 groups: each group included 20 children. These groups were divided as Epilepsy alone, ADHD without EEG changes, ADHD with EEG changes, ADHD with Epilepsy, and Healthy group as a control Inclusion criteria: Both males and females were included, age range between 6- 11 years, diagnosis of ADHD and/or epilepsy was verified and confirmed by a clinical basis. Idiopathic type of epilepsy was included. Exclusion criteria: Children whom caretakers refused to give informed consent, with intelligence quotient below 70, history or current substance use and children with medical or other neurological conditions. Methods All children were subjected to the following after written informed consent from their parents. Psychiatric interview: to collect personal and demographic data Weschler Intelligence Scale for Children-Third Edition (WISC-III): It includes a wide variety of subsets to measure verbal, performance and total IQ. Electroencephalography (EEG): for detection of background waves and presence of any activities of cerebral dysrythmia. The Conners’ Parent Rating scale (CPRS) Third Edition, long format: It is a thorough assessment of attention-deficit/hyperactivity disorder (ADHD) and the most common comorbid problems and disorders. The Child Behavior Checklist (CBCL): to detect emotional and behavioural problems. Socioeconomic Scale: for assessment of social burden and socioeconomic classes. Childhood Autism Spectrum Test (CAST) to screen for possible cases of autism spectrum conditions and related social and communication conditions. The Pediatric Quality of Life Inventory (PedsQL) to evaluate Quality of Life in children. Early Childhood Epilepsy Severity Scale(E-Chess) (applied only for epileptic group) It assesses the severity of seizures Results There was no significant difference found regarding the mean age distribution between the studied groups. While, the proportion of males was significantly higher in the all groups except the group of ADHD with epilepsy, they were almost equal with females The higher proportion of delay of motor development was observed in the group of ADHD with EEG changes and the group of ADHD with epilepsy. Positive family history of seizures was highly observed in the group of epilepsy, while family history of ADHD was highly observed in ADHD groups. According to the clinical variables of epilepsy among the group of epilepsy and the group of ADHD with epilepsy, only the type of seizure was significantly different between the 2 groups. The comparison of EEG changes between the 3 groups (the groups of epilepsy, the group of ADHD with epilepsy and the group of ADHD with EEG changes) showed the highest proportion for generalized paroxysmal changes. According to the E-chess, there was a significant difference regarding number of anticonvulsants used and time period over which seizures occurred between the group of epilepsy and the group of ADHD with epilepsy. On assessment of IQ subscales, the group of ADHD and epilepsy had lower scores than other groups especially in performance IQ score. In the current study, the highest mean of socioeconomic score was in the control group.While, the highest percentage of low class (25%) was observed in the group of ADHD with epilepsy and the group of epilepsy. Regarding PedsQL , the group of ADHD with epilepsy had the poorest PedsQL scores. As regards to CAST scale score, there was no significant difference among the studied groups. Regarding CPRS , combined type of ADHD was predominant in the group of ADHD with EEG changes and the group of ADHD with epilepsy, while hyperactivity type was predominant in the group of ADHD without EEG changes As regard to CBCL, the group of ADHD with EEG changes and ADHD with epilepsy had equal high clinical rating score in internalizing and externalizing problems. In the present study, there was a significant difference in all profile of DSM5 scales of CBCL (anxiety problems, depression problems, somatic problems, attention deficit hyperactivity problems, oppositional defiant problems and conduct problems) among the studied groups. The correlation between total IQ score with socioeconomic and subscales of PedsQL scores among the studied groups showed that physical Summary score, psychological Summary score and total QoL scores had significant positive correlation with total IQ score in the group of ADHD with epilepsy, while no significant correlations were detected in other groups. On assessment of the correlation between socioeconomic score, total IQ score, subscales of PedsQL scores with the clinical variables of epilepsy and E-Chess total severity score in both the group of epilepsy and the group of ADHD with epilepsy showed correlation between age onset of seizure and total IQ score in the group of epilepsy. Meanwhile, other scores did not show any correlation We concluded that patients with ADHD and epilepsy had poorer QoL and performance IQ than either ADHD or epilepsy alone. ADHD with epilepsy was closely related to ADHD with EEG changes regarding other psychiatric comorbidity