Anxiety and depression in parents of a Brazilian non-clinical sample of attention-deficit/ hyperactivity disorder (ADHD) students

P. Mattos,G. Coutinho,D. Fortes,D. Segenreich,G. Pastura

doi:10.1590/s0100-879x2009000500011

Abstract

Higher prevalence rates of anxiety and depression have been reported in parents of children with attention-deficit/hyperactivity disorder (ADHD). The interaction between the burden of ADHD in offspring, a higher prevalence rate of this highly inherited disorder in parents, and comorbidities may explain this finding. Our objective was to investigate levels of ADHD, anxious and depressive symptomatology, and their relationship in parents of ADHD children from a non-clinical sample using a dimensional approach. The sample included 396 students enrolled in all eight grades of a public school who were screened for ADHD using the SNAP IV rating scale. Positive cases were confirmed through a semi-structured interview. Parents of all 26 ADHD students and 31 paired controls were enrolled. A sample of 36 parents of ADHD children (21 mothers, 15 fathers) and 30 parents of control children (18 mothers, 12 fathers) completed the Adult Self Report Scale, State-Trait Anxiety Inventory, and Beck Depression Inventory in order to investigate anxious and depressive symptomatology. Probands' mothers presented a higher level of ADHD symptomatology (with only inattention being a significant cluster). Again, mothers of ADHD children presented higher depressive and anxiety levels; however, these did not correlate with their own ADHD symptomatology. Only trait-anxiety levels were higher in ADHD mothers. Our findings suggest that: 1) anxious and depressive symptoms might be more prevalent in mothers of ADHD students; 2) anxious and depressive symptomatology might be independent of impairment associated with ADHD symptoms; 3) anxious and depressive symptoms are independent of the presence of ADHD.

Highlights

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders of childhood and adolescence, and is characterized by inattention, hyperactivity, and impulsivity symptomatology [1]
After the first phase of the study, which lasted more than one year, 50 of the 57 cases initially evaluated (26 from ADHD students and 31 from control comparison students) could be reached by telephone or regular mail for participation in the second phase
Mothers of ADHD and control children did not differ in formal schooling or age; likewise, fathers of ADHD and control children did not differ in formal schooling and age

Summary

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders of childhood and adolescence, and is characterized by inattention, hyperactivity, and impulsivity symptomatology [1]. The diagnosis in adults may be somewhat difficult due to the paucity of studies validating the number of symptoms for the cutoff, which was first established in field trials with children and adolescents [3]. Kooij et al [5] demonstrated that adults with four or more symptoms presented higher psychosocial impairment than those with three symptoms or less, even after controlling for other disorders and sociodemographic variables. This corroborates the concept of a dimensional disorder. Others have found that there is no equivalence between symptom presentation and severity and presentation of functional impairments [6]

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Results