Key Findings & Observations Psychiatric Comorbidity Patient Population ¬ Mood / affective disorders (61.8% vs. 14.3% in control group) ¬ Conduct & personality disorders (33.2% vs. 0.6%) ¬ Adjustment disorders (18.9% vs. 3.0%) ¬ Sleep disorders (11.3% vs. 2.3%) ¬ Disorders due to substance abuse (7.8% vs. 1.9%) ¬ Disorders due to brain damage (5.1% vs. 0.6%) ¬ Eating disorders (4.3% vs. 0.3%) ¬ Specific developmental disorders (3.8% vs. 0.6%) ¬ Mental retardation (2.4% vs. 0.2%) ¬ Developmental disorders of scholastic skills (2.2% vs. 0.3%) ¬ Habit and impulsive disorders (1.4% vs. 0.0%) ¬ Diseases of the musculoskeletal system (48.4% vs. 21.6%) ¬ Gastrointestinal disorders (41.1% vs. 21.6%) ¬ Metabolic disorders (36.5% vs. 19.0%) ¬ Diseases of the upper respiratory tract (33.7% vs. 15.2%) ¬ Disorders of the genitourinary system (24.8% vs. 13.5%) ¬ Cardiovascular diseases (23.3% vs. 13.5%) ¬ Infectious diseases (22.9% vs. 10.3%) ¬ Diseases of the skin (22.4% vs. 12.8%) ¬ Disorders involving immune mechanisms (22.2% vs. 11.8%) ¬ Injuries, overall (21.4% vs. 14.3%) ¬ Neurological disorders (21.3% vs. 8.9%) ¬ Diseases of the ear (16.0% vs. 8.2%) ¬ Pulmonary diseases (14.1% vs. 5.0%) ¬ Diseases of the blood and blood-forming organs (7.9% vs. 3.6%) 1Note that clusters reported here were defined on the basis of clinical judgment. For further information on cluster definition, please (a) see below, (b) contact us at www.innoval-hc.com. For psychiatric comorbidity, only co-existing disorders with a prevalence rate >1% and a relative risk (RR) >3 are reported; for somatic comorbidity, only clusters with a prevalence rate >5% and a relative risk (RR) > 1.5 are reported. Key Findings: Co-Existing Psychiatric Conditions1 Conspicuous Observations: Co-Existing Somatic Conditions1 ADHD in children and adolescents is associated with substantial comorbidity. Longitudinal studies have shown ADHD to frequently persist into adulthood. Objectives: To use administrative data from Nordbaden / Germany to assess the extent of coexisting medical conditions in grown-ups with a diagnosis of ADHD (Hyperkinetic Disorder: ICD-10 F90.0, F90.1). Methods: Using the comprehensive claims database of the official physicians’ organization of Nordbaden (KVNB, with an insured population of 2.234m in 2003), n=630 ADHD patients age 20 and beyond were identified. The ADHD group was matched with a non-ADHD cohort (n=630) on a 1:1 ratio based on age and gender, and the rate of co-existent conditions was compared between both groups. Chi-square statistics was used to explore levels of significance. Results: The most prevalent psychiatric conditions associated with ADHD in adults included depressive episodes (F32: prevalence 30.3%; relative risk [RR] 7.1*** [p<0.001]), recurrent depressive disorder (F33: 14.3%, RR 12.9***), persistent mood disorders (F34: 7.0%, RR 11.0***), anxiety disorders (F41: 15.7%, RR 5.8***), adjustment disorders (F43: 18.9%; RR 6.6***), other neurotic disorders (F48: 8.6%, RR 6.8***), specific personality disorders (F60: 14.1%; RR 22.3***), other behavioral/emotional disorders with onset in childhood/adolescence (F98: 9.0%; RR 57.0***), mental/behavioral disorders due to substance use (F19: 4.9%; RR 7.8***) or due to use of alcohol (F10: 4.6%; RR 5.8***), and eating disorders (F50: 4.3%, RR 13.5***). Non-psychiatric conditions associated with ADHD included obesity, metabolic, infectious and allergic disorders, including asthma bronchiale, and diseases of the ear and hearing loss but not disorders of the eye and visual disturbances. Conclusions: These data point to significant comorbidity associated with ADHD in grown-ups, thus underscoring the clinical relevance of the condition. They provide a basis for further epidemiological research and for analyses of the cost associated with ADHD in adult patients.