Longitudinal patterns of attention-deficit/hyperactivity disorder children in Shanghai, China

Abstract This study aimed to assess dynamic changes in emotional and behavioral problems among children with Attention-Deficit/Hyperactivity Disorder (ADHD) in Shanghai, China. Using a longitudinal design, school-aged children with ADHD were enrolled and followed, with emotional and behavioral measu...

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Main Authors: XiaoYan Qiu, Daqian Zhu, Xuezhen Fu, Yanyan Huo, Xiangxiang Chen, Jiali Zhang, Shasha Wang, Aidina Aisikeer, Xia Hong, Haidong Lu, Weiming Tang, JinJin Chen
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-02254-x
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author XiaoYan Qiu
Daqian Zhu
Xuezhen Fu
Yanyan Huo
Xiangxiang Chen
Jiali Zhang
Shasha Wang
Aidina Aisikeer
Xia Hong
Haidong Lu
Weiming Tang
JinJin Chen
author_facet XiaoYan Qiu
Daqian Zhu
Xuezhen Fu
Yanyan Huo
Xiangxiang Chen
Jiali Zhang
Shasha Wang
Aidina Aisikeer
Xia Hong
Haidong Lu
Weiming Tang
JinJin Chen
author_sort XiaoYan Qiu
collection DOAJ
description Abstract This study aimed to assess dynamic changes in emotional and behavioral problems among children with Attention-Deficit/Hyperactivity Disorder (ADHD) in Shanghai, China. Using a longitudinal design, school-aged children with ADHD were enrolled and followed, with emotional and behavioral measures repeatedly assessed. Due to varying COVID-19 measures and changing epidemics, and no intervention was admitted, an event-based longitudinal design was adopted, using calendar time from the enrollment of the first participant. Data collection spanned various pandemic control stages, including the Shanghai lockdown (March 28–May 31, 2022). Emotional and behavioral trends were analyzed using a Generalized Additive Model to capture the nonlinear dynamics effectively. Overall, 1102 children with ADHD (mean: 9.2 ± 2.4 years, 83% boys) were enrolled. Emotional and behavioral issues fluctuated over time. Behavioral problems, including inattention, hyperactivity, and conduct issues, peaked around day 260 of isolation and then declined but resurged after the Shanghai lockdown. Emotional issues, such as anxiety and depression, showed a dual-peak pattern, with early pandemic rises and a second peak around day 400. Symptoms rebounded after lockdown and persisted for an extended period. Sub-analyses revealed that boys had higher scores in hyperactivity and oppositional defiance than girls, with no significant gender differences in emotional problems. ADHD-PI children had higher emotional problem scores, while ADHD-HI children exhibited more severe behavioral issues. This study highlights the substantial impact of prolonged COVID-19 measures on emotional and behavioral problems in ADHD children, particularly increased adaptive pressures post-lockdown. Phase-specific, individualized interventions are crucial to mitigate these challenges.
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spelling doaj-art-46044012ea7c4d95b4a9014eb958758f2025-08-20T03:27:09ZengNature PortfolioScientific Reports2045-23222025-06-0115111010.1038/s41598-025-02254-xLongitudinal patterns of attention-deficit/hyperactivity disorder children in Shanghai, ChinaXiaoYan Qiu0Daqian Zhu1Xuezhen Fu2Yanyan Huo3Xiangxiang Chen4Jiali Zhang5Shasha Wang6Aidina Aisikeer7Xia Hong8Haidong Lu9Weiming Tang10JinJin Chen11Department of Child Health Care, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Child Health Care, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversitySchool of Animation and Motion, Savannah College of Art and DesignDepartment of Child Health Care, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Child Health Care, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityFenglin Community Health Service Center in Xuhui DistrictDepartment of Child Health Care, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Child Health Care, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Child Health Care, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversitySchool of Medicine, Yale University School of MedicineInstitute for Global Health and Infectious Diseases, University of North Carolina at Chapel HillDepartment of Child Health Care, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityAbstract This study aimed to assess dynamic changes in emotional and behavioral problems among children with Attention-Deficit/Hyperactivity Disorder (ADHD) in Shanghai, China. Using a longitudinal design, school-aged children with ADHD were enrolled and followed, with emotional and behavioral measures repeatedly assessed. Due to varying COVID-19 measures and changing epidemics, and no intervention was admitted, an event-based longitudinal design was adopted, using calendar time from the enrollment of the first participant. Data collection spanned various pandemic control stages, including the Shanghai lockdown (March 28–May 31, 2022). Emotional and behavioral trends were analyzed using a Generalized Additive Model to capture the nonlinear dynamics effectively. Overall, 1102 children with ADHD (mean: 9.2 ± 2.4 years, 83% boys) were enrolled. Emotional and behavioral issues fluctuated over time. Behavioral problems, including inattention, hyperactivity, and conduct issues, peaked around day 260 of isolation and then declined but resurged after the Shanghai lockdown. Emotional issues, such as anxiety and depression, showed a dual-peak pattern, with early pandemic rises and a second peak around day 400. Symptoms rebounded after lockdown and persisted for an extended period. Sub-analyses revealed that boys had higher scores in hyperactivity and oppositional defiance than girls, with no significant gender differences in emotional problems. ADHD-PI children had higher emotional problem scores, while ADHD-HI children exhibited more severe behavioral issues. This study highlights the substantial impact of prolonged COVID-19 measures on emotional and behavioral problems in ADHD children, particularly increased adaptive pressures post-lockdown. Phase-specific, individualized interventions are crucial to mitigate these challenges.https://doi.org/10.1038/s41598-025-02254-xAttention-deficit/hyperactivity disorderCOVIDDynamic change
spellingShingle XiaoYan Qiu
Daqian Zhu
Xuezhen Fu
Yanyan Huo
Xiangxiang Chen
Jiali Zhang
Shasha Wang
Aidina Aisikeer
Xia Hong
Haidong Lu
Weiming Tang
JinJin Chen
Longitudinal patterns of attention-deficit/hyperactivity disorder children in Shanghai, China
Scientific Reports
Attention-deficit/hyperactivity disorder
COVID
Dynamic change
title Longitudinal patterns of attention-deficit/hyperactivity disorder children in Shanghai, China
title_full Longitudinal patterns of attention-deficit/hyperactivity disorder children in Shanghai, China
title_fullStr Longitudinal patterns of attention-deficit/hyperactivity disorder children in Shanghai, China
title_full_unstemmed Longitudinal patterns of attention-deficit/hyperactivity disorder children in Shanghai, China
title_short Longitudinal patterns of attention-deficit/hyperactivity disorder children in Shanghai, China
title_sort longitudinal patterns of attention deficit hyperactivity disorder children in shanghai china
topic Attention-deficit/hyperactivity disorder
COVID
Dynamic change
url https://doi.org/10.1038/s41598-025-02254-x
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