In Nepal, an underdeveloped country with multiple adversities [33], the challenges brought forward by these comorbid conditions are considerable; this resource-deficient country is not prepared to cope with them.
The first position is not consistent with data demonstrating that environmental factors play a role in ADHD (low economic status, severe child mistreatment, maternal smoking during pregnancy, premature birth, teenager pregnancy and other environmental adversities) [22].
The difference between the groups of no adversities, 1 2 adversities and 3 6 adversities became evident after 3 years of follow-up and widened during the course of time.
Childhood adversities: 29 questions from the Conflict Tactics Scale 25 and the Childhood Trauma Questionnaire.
Of those who endorsed two or more childhood adversities, 10.8% reported suicidal ideation and 8.6% did not (table 2).
Just over half of cases (52.6%) in the present sample were not exposed to any of these adversities, 28.2% to one, and 19.3% to two or more.
This result was confirmed by Breslau [ 39] who detected a weaker but still significant association between nicotine dependence and high school dropout (OR adjusted for socio-demographic characteristics and childhood adversities: 1.52; 95% CI: 1.13 to 2.03).
In contrast, later childhood adversities (5 11 years) showed that at 14 years there were two adversity classes, hazardous and discordant, with elevated depression scores when compared to both the optimal and aberrant parenting classes.
> In adolescent boys exposed to early childhood adversities (0 5 years), mean depression scores at age 14 were significantly increased in the hazardous compared to the optimal and the aberrant parenting classes.
Some of the associations are consistent with other studies which showed a positive association of depression with being less educated, socioeconomic adversity [ 10, 13, 19, 37], verbal abuse and relationship problems [ 19, 20].
