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Published in: European Child & Adolescent Psychiatry 1/2015

01-01-2015 | Original Paper

Risk factors for incident major depressive disorder in children and adolescents with attention-deficit/hyperactivity disorder

Authors: Jeanette M. Jerrell, Roger S. McIntyre, Yong-Moon Mark Park

Published in: European Child & Adolescent Psychiatry | Issue 1/2015

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Abstract

The greater burden of illness in youth with co-occurring attention-deficit/hyperactivity disorder (ADHD) and major depressive disorder (MDD) deserves further investigation, specifically regarding the influence of other psychiatric or medical conditions and the pharmacotherapies prescribed. A retrospective cohort design was employed, using South Carolina’s (USA) Medicaid claims’ dataset covering outpatient and inpatient medical services, and medication prescriptions between January, 1996 and December, 2006 for patients ≤17 years of age. The cohort included 22,452 cases diagnosed with ADHD at a mean age 7.8 years; 1,259 (5.6 %) cases were diagnosed with MDD at a mean age of 12.1 years. The probability of a child with ADHD developing MDD was significantly associated with a comorbid anxiety disorder (aOR = 3.53), CD/ODD (aOR = 3.45), or a substance use disorder (aOR = 2.31); being female (aOR = 1.77); being treated with pemoline (aOR = 1.69), atomoxetine (aOR = 1.31), or mixed amphetamine salts (aOR = 1.28); a comorbid obesity diagnosis (aOR = 1.29); not being African American (aOR = 1.23), and being older at ADHD diagnosis (aOR = 1.09). Those developing MDD also developed several comorbid disorders later than the ADHD-only cohort, i.e., conduct disorder/oppositional-defiant disorder (CD/ODD), at mean age of 10.8 years, obesity at 11.6 years, generalized anxiety disorder at 12.2 years, and a substance use disorder at 15.7 years of age. Incident MDD was more likely in individuals clustering several demographic, clinical, and treatment factors. The phenotypic progression suggested herein underscores the need for coordinated early detection and intervention to prevent or delay syndromal MDD, or to minimize its severity and associated impairment over time.
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Metadata
Title
Risk factors for incident major depressive disorder in children and adolescents with attention-deficit/hyperactivity disorder
Authors
Jeanette M. Jerrell
Roger S. McIntyre
Yong-Moon Mark Park
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
European Child & Adolescent Psychiatry / Issue 1/2015
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-014-0541-z

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