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      Factors associated with symptoms of attention deficit hyperactivity disorder among medical students in Cameroon: a web-based cross-sectional study

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          Abstract

          Introduction

          Attention deficit hyperactivity disorder (ADHD) is a chronic mental disorder that is associated with poor productivity, with a significant impact on the quality of life.

          Objectives

          To determine factors associated with symptoms of ADHD among medical students in Cameroon.

          Design

          A web-based cross-sectional study.

          Setting

          Participants were recruited through a social media platform, WhatsApp, from 24 June to 2 September 2018.

          Participants

          Medical students aged 18 years and older from seven medical schools in Cameroon. All non-medical students and all medical residents were excluded.

          Results

          Data from a total of 491 eligible participants were analysed. The median age was 25 (IQR 21–25) years and 54% were of the participants were female. The prevalence of self-reported symptoms of ADHD was 24.4% (95% CI 20.6% to 28.3%). Histories of chronic disease (adjusted OR (AOR) 2.96; 95% CI 1.49 to 5.86, p=0.002), family history of ADHD (AOR 3.38; 95% CI 1.04 to 10.44, p=0.035), severe depression (AOR=3.49; 95% CI 1.82 to 6.77, p<0.001) and anxiety disorder (AOR 2.06; 95% CI 1.25 to 3.36, p=0.004) were found to be independently associated with the symptoms of ADHD.

          Conclusion

          ADHD may be a highly prevalent mental disorder among medical students, and is associated with severe depression, anxiety disorders and chronic diseases. There is a need to conduct a large-scale prospective cohort study with interviews to estimate the true prevalence and incidence of ADHD among medical students in Cameroon, and to determinant the risk factors associated with the disorder.

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          Most cited references27

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          Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives

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            • Article: not found

            Comparative fit indexes in structural models.

            P. Bentler (1990)
            Normed and nonnormed fit indexes are frequently used as adjuncts to chi-square statistics for evaluating the fit of a structural model. A drawback of existing indexes is that they estimate no known population parameters. A new coefficient is proposed to summarize the relative reduction in the noncentrality parameters of two nested models. Two estimators of the coefficient yield new normed (CFI) and nonnormed (FI) fit indexes. CFI avoids the underestimation of fit often noted in small samples for Bentler and Bonett's (1980) normed fit index (NFI). FI is a linear function of Bentler and Bonett's non-normed fit index (NNFI) that avoids the extreme underestimation and overestimation often found in NNFI. Asymptotically, CFI, FI, NFI, and a new index developed by Bollen are equivalent measures of comparative fit, whereas NNFI measures relative fit by comparing noncentrality per degree of freedom. All of the indexes are generalized to permit use of Wald and Lagrange multiplier statistics. An example illustrates the behavior of these indexes under conditions of correct specification and misspecification. The new fit indexes perform very well at all sample sizes.
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              The worldwide prevalence of ADHD: a systematic review and metaregression analysis.

              The worldwide prevalence estimates of attention deficit hyperactivity disorder (ADHD)/hyperkinetic disorder (HD) are highly heterogeneous. Presently, the reasons for this discrepancy remain poorly understood. The purpose of this study was to determine the possible causes of the varied worldwide estimates of the disorder and to compute its worldwide-pooled prevalence. The authors searched MEDLINE and PsycINFO databases from January 1978 to December 2005 and reviewed textbooks and reference lists of the studies selected. Authors of relevant articles from North America, South America, Europe, Africa, Asia, Oceania, and the Middle East and ADHD/HD experts were contacted. Surveys were included if they reported point prevalence of ADHD/HD for subjects 18 years of age or younger from the general population or schools according to DSM or ICD criteria. The literature search generated 9,105 records, and 303 full-text articles were reviewed. One hundred and two studies comprising 171,756 subjects from all world regions were included. The ADHD/HD worldwide-pooled prevalence was 5.29%. This estimate was associated with significant variability. In the multivariate metaregression model, diagnostic criteria, source of information, requirement of impairment for diagnosis, and geographic origin of the studies were significantly associated with ADHD/HD prevalence rates. Geographic location was associated with significant variability only between estimates from North America and both Africa and the Middle East. No significant differences were found between Europe and North America. Our findings suggest that geographic location plays a limited role in the reasons for the large variability of ADHD/HD prevalence estimates worldwide. Instead, this variability seems to be explained primarily by the methodological characteristics of studies.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2020
                7 May 2020
                : 10
                : 5
                : e037297
                Affiliations
                [1 ]departmentGraduate School of Tropical Medicine and Global Health , Nagasaki University , Nagasaki, Japan
                [2 ]departmentFaculty of Health Sciences , University of Bamenda, Bamenda, Cameroon , Bamenda, Cameroon
                [3 ]Medical Department, GiftedMom, Yaoundé, Cameroon , Yaounde, Cameroon
                [4 ]departmentDepartment of Dental Surgery , Mbingo Baptist Hospital , Belo, Cameroon
                [5 ]departmentDepartment of Population Health , Université Catholique de l’Afrique Centrale , Yaounde, Cameroon
                [6 ]departmentNuffield Department of Population Health , University of Oxford , Oxford, Oxfordshire, UK
                [7 ]departmentInstitute of Health Informatics , University College London , London, UK
                [8 ]departmentDepartment of Health Research , Health Education and Research Organisation (HERO) , Buea, Cameroon
                Author notes
                [Correspondence to ] Dr Valirie Ndip Agbor; nvagbor@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-6708-6852
                Article
                bmjopen-2020-037297
                10.1136/bmjopen-2020-037297
                7228532
                32385066
                e41e61bf-9f3d-4ea1-82ab-f876f72cbdd6
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 27 January 2020
                : 23 March 2020
                : 16 April 2020
                Categories
                Mental Health
                1506
                1712
                Original research
                Custom metadata
                unlocked

                Medicine
                psychiatry,epidemiology,medical education & training
                Medicine
                psychiatry, epidemiology, medical education & training

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