Psychiatric Comorbidity in Adult Attention Deficit Hyperactivity Disorder: Findings From Multiplex Families

Center for Neurobehavioral Genetics, David Geffen School of Medicine, Suite 1414, 300 UCLA Medical Plaza, Los Angeles, CA 90095, USA.
American Journal of Psychiatry (Impact Factor: 12.3). 10/2005; 162(9):1621-7. DOI: 10.1176/appi.ajp.162.9.1621
Source: PubMed


Patterns of psychiatric comorbidity were assessed in adults with and without attention deficit hyperactivity disorder (ADHD) identified through a genetic study of families containing multiple children with ADHD.
Lifetime ADHD and comorbid psychopathology were assessed in 435 parents of children with ADHD. Rates and mean ages at onset of comorbid psychopathology were compared in parents with lifetime ADHD, parents with persistent ADHD, and those without ADHD. Age-adjusted rates of comorbidity were compared with Kaplan-Meier survival curves. Logistic regression was used to assess additional risk factors for conditions more frequent in ADHD subjects.
The parents with ADHD were significantly more likely to be unskilled workers and less likely to have a college degree. ADHD subjects had more lifetime psychopathology; 87% had at least one and 56% had at least two other psychiatric disorders, compared with 64% and 27%, respectively, in non-ADHD subjects. ADHD was associated with greater disruptive behavior, substance use, and mood and anxiety disorders and with earlier onset of major depression, dysthymia, oppositional defiant disorder, and conduct disorder. Group differences based on Kaplan-Meier age-corrected risks were consistent with those for raw frequency distributions. Male sex added risk for disruptive behavior disorders. Female sex and oppositional defiant disorder contributed to risk for depression and anxiety. ADHD was not a significant risk factor for substance use disorders when male sex, disruptive behavior disorders, and socioeconomic status were controlled.
Adult ADHD is associated with significant lifetime psychiatric comorbidity that is not explained by clinical referral bias.

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    • "The influence of impulsiveness on diverse social and occupational impairment was studied in 135 young adults; it was found that when ADHD-symptoms persisted into adulthood, impulsiveness contributed significantly to occupational, educational, and financial impairments (Barkley & Fischer, 2010). A study of 481 adults previously diagnosed with ADHD found that the greater the conduct disorder indicators, the greater the drug consumption (Waschbusch, 2002); this condition has also been observed in other studies (McGough et al., 2005). "
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    ABSTRACT: To evaluate and describe the performance during the learning process of risk-detection versus risk-benefit processing in adolescents diagnosed with ADHD. Thirty-five adolescents with ADHD and 26 paired controls participated. The tests applied are Iowa-type children version paradigm and Stroop test. Adolescents with ADHD exhibited lower risk-benefit processing capacity and lower ability to detect risk selections; main findings also indicate that adolescents with ADHD were slower to learn to avoid risk choices. In addition, they also presented a deficient inhibitory control. Results confirm the presence of a deficit in advantageous choice in adolescents with ADHD. By providing a measure of risk choice-and not only a net score-we show that adolescents with ADHD also fail to avoid risk choices. This deficit is mainly because they are slower in learning how to avoid risk choices, and not simply deficient. Literature is scarce concerning studies with Iowa-type paradigms in samples intregated exclusively by adolescents. More research is needed to clarify the nature of these deficiencies. © 2015 SAGE Publications.
    Journal of Attention Disorders 04/2015; DOI:10.1177/1087054715573995 · 3.78 Impact Factor
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    • "In those with a pre-existing diagnosis of schizophrenia, the use of methylphenidate has been shown to worsen the condition (Ekinci and Sabuncuoglu, 2011). People with ADHD are also more likely to consume illicit drugs known to increase the risk of psychosis, including cannabis (Faraone et al., 2007) and psycho-stimulants (McGough et al., 2005). An alternative pathway between ADHD symptoms and psychosis might be provided by dysphoric mood. "

    European Psychiatry 03/2015; 30:880. DOI:10.1016/S0924-9338(15)30688-X · 3.44 Impact Factor
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    • "Severity of lifetime conduct disorder was predictive of several of the most salient outcomes (failure to graduate, earlier sexual intercourse, early parenthood), whereas attention-deficit/hyperactivity disorder and oppositional defiant disorder at work were predictive of job performance and risk of being fired (Barkley et al., 2006). ADHD is also found to include comorbidity with other psychiatric conditions, like disruptive behaviour, substance use, mood and anxiety disorders, oppositional defiant disorder, and conduct disorder, which also may interact with learning and education (McGough et al., 2005). We have less information on how attention deficits stemming from other psychiatric conditions interfere with the requirements of education (Balint et al., 2008). "

    02/2015; 2(1). DOI:10.15845/jper.v2i1.702
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