ADHD characteristics: I. Concurrent co-morbidity patterns in children &amp; adolescents

Josephine Elia,Paul Ambrosini,Wade Berrettini

doi:10.1186/1753-2000-2-15

Abstract

Objective342 Caucasian subjects with attention deficit/hyperactivity disorder (ADHD) were recruited from pediatric and behavioral health clinics for a genetic study. Concurrent comorbidity was assessed to characterize the clinical profile of this cohort.MethodsSubjects 6 to 18 years were diagnosed with the Schedule for Affective Disorders & Schizophrenia for School aged Children (K-SADS-P IVR).ResultsThe most prevalent diagnoses co-occurring with ADHD were Oppositional Defiant Disorder (ODD) (40.6%), Minor Depression/Dysthymia (MDDD) (21.6%), and Generalized Anxiety Disorder (GAD) (15.2%). In Inattentive ADHD (n = 106), 20.8% had MDDD, 20.8% ODD, and 18.6% GAD; in Hyperactive ADHD (n = 31) 41.9% had ODD, 22.2% GAD, and 19.4% MDDD. In Combined ADHD, (n = 203), 50.7% had ODD, 22.7% MDDD and 12.4% GAD. MDDD and GAD were equally prevalent in the ADHD subtypes but, ODD was significantly more common among Combined and Hyperactive ADHD compared to Inattentive ADHD. The data suggested a subsample of Irritable prepubertal children exhibiting a diagnostic triad of ODD, Combined ADHD, and MDDD may account for the over diagnosing of Bipolar Disorder.ConclusionAlmost 2/3rd of ADHD children have impairing comorbid diagnoses; Hyperactive ADHD represents less than 10% of an ADHD sample; ODD is primarily associated with Hyperactive and Combined ADHD; and, MDDD may be a significant morbidity for ADHD youths from clinical samples.

Highlights

The primary goal of this report is to characterize the concurrent comorbidy patterns identified in a clinical sample of attention deficit/hyperactivity disorder (ADHD) subjects recruited for this genetic study
The relevance of these issues for the present study is that the focus of the genetic analysis of ADHD must consider the comorbid patterns of ADHD itself
The sample consists of 342 Caucasian patients all with a current diagnosis of ADHD

Summary

Introduction

The primary goal of this report is to characterize the concurrent comorbidy patterns identified in a clinical sample of ADHD subjects recruited for this genetic study. Comorbidity can be classified into two broad patterns, homotypic or heterotypic [1]. These characteristics refer, respectively, to the continuity of a diagnostic pattern or the emergence of different diagnostic patterns over a lifetime. For ADHD these types of comorbidity could be represented by residual ADHD in adults or the emergence of an affective syndrome at some time in the course of ADHD. The relevance of these issues for the present study is that the focus of the genetic analysis of ADHD must consider the comorbid patterns of ADHD itself. By more clearly defining the ADHD construct will there be any success in identifying true genetic/biological markers for this disorder [3]

Methods

Results

Conclusion