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Child and Adolescent Psychiatry and Mental Health
Published in: Child and Adolescent Psychiatry and Mental Health 1/2008

Open Access 01-12-2008 | Research

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

Authors: Josephine Elia, Paul Ambrosini, Wade Berrettini

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2008

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Abstract

Objective

342 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.

Methods

Subjects 6 to 18 years were diagnosed with the Schedule for Affective Disorders & Schizophrenia for School aged Children (K-SADS-P IVR).

Results

The 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.

Conclusion

Almost 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.
Literature
1.
Angold A, Costello EJ, Erkanli A: Comorbidity. Journal of child psychology and psychiatry, and allied disciplines. 1999, 40 (1): 57-87. 10.1017/S0021963098003448.CrossRefPubMed
2.
Caron C, Rutter M: Comorbidity in child psychopathology: concepts, issues and research strategies. Journal of child psychology and psychiatry, and allied disciplines. 1991, 32 (7): 1063-1080. 10.1111/j.1469-7610.1991.tb00350.x.CrossRefPubMed
3.
van Praag HM: Over the mainstream: diagnostic requirements for biological psychiatric research. Psychiatry Res. 1997, 72 (3): 201-212. 10.1016/S0165-1781(97)00103-0.CrossRefPubMed
4.
Barkley RA: Attention-Deficit Hyperactivity Disorder. A Handbook for Diagnosis and Treatment. 2006, New York , Guilford Press, 3rd Edition
5.
Group MTAC: A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry. 1999, 56 (12): 1073-1086. 10.1001/archpsyc.56.12.1073.CrossRef
6.
Busch B, Biederman J, Cohen LG, Sayer JM, Monuteaux MC, Mick E, Zallen B, Faraone SV: Correlates of ADHD among children in pediatric and psychiatric clinics. Psychiatr Serv. 2002, 53 (9): 1103-1111. 10.1176/appi.ps.53.9.1103.CrossRefPubMed
7.
Biederman J, Monuteaux MC, Mick E, Spencer T, Wilens TE, Klein KL, Price JE, Faraone SV: Psychopathology in females with attention-deficit/hyperactivity disorder: a controlled, five-year prospective study. Biol Psychiatry. 2006, 60 (10): 1098-1105. 10.1016/j.biopsych.2006.02.031.CrossRefPubMed
8.
Biederman J, Faraone S, Milberger S, Guite J, Mick E, Chen L, Mennin D, Marrs A, Ouellette C, Moore P, Spencer T, Norman D, Wilens T, Kraus I, Perrin J: A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch Gen Psychiatry. 1996, 53 (5): 437-446.CrossRefPubMed
9.
Ambrosini PJ: Historical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). J Am Acad Child Adolesc Psychiatry. 2000, 39 (1): 49-58. 10.1097/00004583-200001000-00016.CrossRefPubMed
10.
Jensen PS, Hinshaw SP, Kraemer HC, Lenora N, Newcorn JH, Abikoff HB, March JS, Arnold LE, Cantwell DP, Conners CK, Elliott GR, Greenhill LL, Hechtman L, Hoza B, Pelham WE, Severe JB, Swanson JM, Wells KC, Wigal T, Vitiello B: ADHD comorbidity findings from the MTA study: comparing comorbid subgroups. J Am Acad Child Adolesc Psychiatry. 2001, 40 (2): 147-158. 10.1097/00004583-200102000-00009.CrossRefPubMed
11.
Eiraldi RB, Power TJ, Nezu CM: Patterns of comorbidity associated with subtypes of attention-deficit/hyperactivity disorder among 6- to 12-year-old children. J Am Acad Child Adolesc Psychiatry. 1997, 36 (4): 503-514. 10.1097/00004583-199704000-00013.CrossRefPubMed
12.
Willcutt EG, Pennington BF, Chhabildas NA, Friedman MC, Alexander J: Psychiatric comorbidity associated with DSM-IV ADHD in a nonreferred sample of twins. J Am Acad Child Adolesc Psychiatry. 1999, 38 (11): 1355-1362. 10.1097/00004583-199911000-00009.CrossRefPubMed
13.
Eiraldi RB, Power TJ, Karustis JL, Goldstein SG: Assessing ADHD and comorbid disorders in children: the Child Behavior Checklist and the Devereux Scales of Mental Disorders. Journal of clinical child psychology. 2000, 29 (1): 3-16. 10.1207/S15374424jccp2901_2.CrossRefPubMed
14.
Power TJ, Costigan TE, Eiraldi RB, Leff SS: Variations in anxiety and depression as a function of ADHD subtypes defined by DSM-IV: do subtype differences exist or not?. Journal of abnormal child psychology. 2004, 32 (1): 27-37. 10.1023/B:JACP.0000007578.30863.93.CrossRefPubMed
15.
Takahashi K, Miyawaki D, Suzuki F, Mamoto A, Matsushima N, Tsuji H, Horino A, Ballas PA, Kiriike N: Hyperactivity and comorbidity in Japanese children with attention-deficit/hyperactivity disorder. Psychiatry and clinical neurosciences. 2007, 61 (3): 255-262. 10.1111/j.1440-1819.2007.01651.x.CrossRefPubMed
16.
Chang FM, Kidd JR, Livak KJ, Pakstis AJ, Kidd KK: The world-wide distribution of allele frequencies at the human dopamine D4 receptor locus. Hum Genet. 1996, 98 (1): 91-101. 10.1007/s004390050166.CrossRefPubMed
17.
Spitzer RL, Endicott J, Robins E: Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry. 1978, 35 (6): 773-782.CrossRefPubMed
18.
Association AP: Diagnostic and Statistical Manual of Mental Disorders. 4th ed. DSM-IV. 1994, Washington, DC , American Psychiatric Association, 4th
19.
Hollingshead AB: Four Factor Index of Social Status. 1975, New Haven
20.
Hay DA, Bennett KS, Levy F, Sergeant J, Swanson J: A twin study of attention-deficit/hyperactivity disorder dimensions rated by the strengths and weaknesses of ADHD-symptoms and normal-behavior (SWAN) scale. Biol Psychiatry. 2007, 61 (5): 700-705. 10.1016/j.biopsych.2006.04.040.CrossRefPubMed
21.
Kadesjo B, Gillberg C: The comorbidity of ADHD in the general population of Swedish school-age children. J Child Psychol Psychiatry. 2001, 42 (4): 487-492. 10.1017/S0021963001007090.CrossRefPubMed
22.
Froehlich TE, Lanphear BP, Epstein JN, Barbaresi WJ, Katusic SK, Kahn RS: Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Arch Pediatr Adolesc Med. 2007, 161 (9): 857-864. 10.1001/archpedi.161.9.857.CrossRefPubMed
23.
Smalley SL, McGough JJ, Moilanen IK, Loo SK, Taanila A, Ebeling H, Hurtig T, Kaakinen M, Humphrey LA, McCracken JT, Varilo T, Yang MH, Nelson SF, Peltonen L, Jarvelin MR: Prevalence and psychiatric comorbidity of attention-deficit/hyperactivity disorder in an adolescent Finnish population. J Am Acad Child Adolesc Psychiatry. 2007, 46 (12): 1575-1583.CrossRefPubMed
24.
Faraone SV, Biederman J, Weber W, Russell RL: Psychiatric, neuropsychological, and psychosocial features of DSM-IV subtypes of attention-deficit/hyperactivity disorder: results from a clinically referred sample. J Am Acad Child Adolesc Psychiatry. 1998, 37 (2): 185-193. 10.1097/00004583-199802000-00011.CrossRefPubMed
25.
Biederman J, Munir K, Knee D, Armentano M, Autor S, Waternaux C, Tsuang M: High rate of affective disorders in probands with attention deficit disorder and in their relatives: a controlled family study. Am J Psychiatry. 1987, 144 (3): 330-333.CrossRefPubMed
26.
Biederman J, Faraone SV, Keenan K, Tsuang MT: Evidence of familial association between attention deficit disorder and major affective disorders. Arch Gen Psychiatry. 1991, 48 (7): 633-642.CrossRefPubMed
27.
Costello EJ, Worthman C, Erkanli A, Angold A: Prediction from low birth weight to female adolescent depression: a test of competing hypotheses. Arch Gen Psychiatry. 2007, 64 (3): 338-344. 10.1001/archpsyc.64.3.338.CrossRefPubMed
28.
Wade TJ, Cairney J, Pevalin DJ: Emergence of gender differences in depression during adolescence: national panel results from three countries. J Am Acad Child Adolesc Psychiatry. 2002, 41 (2): 190-198. 10.1097/00004583-200202000-00013.CrossRefPubMed
29.
Mick E, Spencer T, Wozniak J, Biederman J: Heterogeneity of irritability in attention-deficit/hyperactivity disorder subjects with and without mood disorders. Biol Psychiatry. 2005, 58 (7): 576-582. 10.1016/j.biopsych.2005.05.037.CrossRefPubMed
30.
Ambrosini PJ, Myers GM, Bianchi MD, Metz C: Irritable and depressed mood: Are they synonymous?: San Diego, CA.1997, American Psychiatric Association, 187.
31.
Vance A, Sanders M, Arduca Y: Dysthymic disorder contributes to oppositional defiant behaviour in children with Attention Deficit Hyperactivity Disorder, combined type (ADHD-CT). J Affect Disord. 2005, 86 (2-3): 329-333. 10.1016/j.jad.2005.03.007.CrossRefPubMed
32.
Masi G, Perugi G, Millepiedi S, Mucci M, Pari C, Pfanner C, Berloffa S, Toni C: Clinical implications of DSM-IV subtyping of bipolar disorders in referred children and adolescents. J Am Acad Child Adolesc Psychiatry. 2007, 46 (10): 1299-1306. 10.1097/chi.0b013e3180f62eba.CrossRefPubMed
33.
Pliszka SR: Patterns of psychiatric comorbidity with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am. 2000, 9 (3): 525-40, vii.PubMed
Metadata
Title
ADHD characteristics: I. Concurrent co-morbidity patterns in children & adolescents
Authors
Josephine Elia
Paul Ambrosini
Wade Berrettini
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2008
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/1753-2000-2-15

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