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2020

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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ADHD AND EARLY CHILDHOOD RESIDENTIAL CARE. A STUDY CASE ABOUT THE CONSEQUENCES OF THE FIRST YEARS LACK OF AFFECT.

Rosario Lineros Linero1; Lara Martin-Garcia2; Catarina Garcia Ribeiro3; Juan Lull-Carmona4; Juan Ortiz-Guerra5

1- Médico Interno, Departamento de Psiquiatria, Hospital Juan Ramón Jiménez, Huelva, Espanha.
2- Médico Interno, Departamento de Psiquiatria, Benito Menni Complex Assistencial em Salut Mental, Sant Boi de Llobregat, Espanha.
3- Médico Interno, Especialidade de Psiquiatria da Infância e da Adolescência, Área da Mulher, Criança e Adolescente, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa.
4- Médico Interno, Departamento de Psiquiatria, Hospital Arnaude Vilanova, Valencia, Espanha.
5- Médico Especialista, Departamento de Psiquiatria Infanto-Juvenil Hospital Sant Joan de Déu, Barcelona, Espanha.

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Introduction: From a Study Case of a 9-year-old male adopted child who comes to Child and Adolescent Psychiatry Unit of ADHD of Hospital Sant Joan de Déu (HSJD) in Barcelona, due to behavioural problems, dyslexia and poor school performance, the aim of this study was a reflection about early childhood exposure to neglection and institutionalization and possible consequences.
Clinical Case: The child is from Russia and lives with his adopted Spanish family since he was 2 years old. He had been institutionalized in the first two years of life and had personal background of fetal exposure to alcohol. He now meets the criteria of combined ADHD and Oppositional Defiant Disorder (DSM-5). A literature search has been made in PudMed, Cochrane and UpToDate with the keywords (MESH) "institutionalization", "ADHD" "deprivation care".
Conclusion: Systematic studies showed that institutionalized children in the first 24 months are more likely to have a neurodevelopmental disorder such as ADHD. The time of staying in the institution is also related to the severity of the symptoms. It is important to analyze the personal and family history of patients first years, especially if there are doubts such as possible environmental factors that can be related to ADHD development. It is necessary to promote studies in the field of negligence in the early childhood care and the appearance of symptoms compatible with ADHD.

Keywords: ADHD, deprivation care, institutionalization.