Youths with ADHD with and without tic disorders: Comorbid psychopathology, executive function and social adjustment

Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Research in developmental disabilities (Impact Factor: 4.41). 05/2012; 33(3):951-63. DOI: 10.1016/j.ridd.2012.01.001
Source: PubMed


Attention deficit/hyperactivity disorder (ADHD) and tic disorders (TD) commonly co-occur. Clarifying the psychiatric comorbidities, executive functions and social adjustment difficulties in children and adolescents of ADHD with and without TD is informative to understand the developmental psychopathology and to identify their specific clinical needs. This matched case-control study compared three groups (n=40 each) of youths aged between 8 and 16 years: ADHD with co-occurring TD (ADHD+TD), ADHD without TD (ADHD-TD) and typically developing community controls. Both ADHD groups had more co-occurring oppositional defiant disorder than the control group, and the presence of TD was associated with more anxiety disorders. TD did not impose additional executive function impairments or social adjustment difficulties on ADHD. Interestingly, for youths with ADHD, the presence of TD was associated with less interpersonal difficulties at school, compared to those without TD. The potential various directions of effects from co-occurring TD should be carefully evaluated and investigated for youths with ADHD.

Download full-text


Available from: Meng-Chuan Lai
  • Source
    • "A higher score indicates greater perceived family support [61] [62]. The Chinese Family APGAR questionnaire has been used in assessing perceived family support in clinic-based [49] [54] [55] [63] [64] and in community-based [48] [58] [65] studies in Taiwan. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Eveningness and Internet addiction are major concerns in adolescence and young adulthood. We investigated the relationship between morningness-eveningness and compulsive Internet use in young adults and explored the moderating effects of perceived parenting styles and family support on such relationships. The participants consisted of 2731 incoming college students (men, 52.4%; mean age, 19.4±3.6years) from a National University in Taiwan. Each participant completed the questionnaires, which included the Morningness-Eveningness Scale (MES), the Yale-Brown Obsessive Compulsive Scale modified for Internet use (YBOCS-IU), the Parental Bonding Instrument for parenting style, the Family Adaptation, Partnership, Growth, Affection, and Resolve questionnaire (APGAR) for perceived family support, and the Adult Self-Report Inventory-4 (ASRI-4) for psychopathology. The morning (n=459), intermediate (n=1878), and evening (n=394) groups were operationally defined by the MES t scores. The results showed that eveningness was associated with greater weekend sleep compensation, increased compulsive Internet use, more anxiety, poorer parenting styles, and less family support; additionally, the most associated variables for increased compulsive Internet use were the tendency of eveningness, male gender, more anxiety symptoms, less maternal affection/care, and a lower level of perceived family support. The negative association between the morning type and compulsive Internet use severity escalated with increased maternal affection/care and decreased with increased perceived family support. The positive association between the evening type and compulsive Internet use severity declined with increased maternal protection. However, the father's parenting style did not influence the relationship between morningness-eveningness and compulsive Internet use severity. Our findings imply that sleep schedule and the parental and family process should be part of specific measures for prevention and intervention of compulsive Internet use.
    Full-text · Article · Sep 2013 · Sleep Medicine
  • Source
    • "It might be speculated that this could be related to the comorbidity between TDs and ADHD. The post hoc analyses, however, showed no support for this notion as there was no risk increase for violent criminality in children with ADHD and concomitant TDs, and recent research suggests that TDs comorbid with ADHD might improve adaptation in terms of neuropsychological performance and interpersonal difficulties in school compared to ADHD only (Greimel et al. 2008; Lin et al. 2012). Although, TDs are reported to be associated with increased rates of drug and alcohol abuse (Teive et al. 2001), controlling for substance misuse did not explain the association between TDs and violent crime. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The longitudinal relationship between attention deficit hyperactivity disorder (ADHD) and violent criminality has been extensively documented, while long-term effects of autism spectrum disorders (ASDs), tic disorders (TDs), and obsessive compulsive disorder (OCD) on criminality have been scarcely studied. Using population-based registers of all child and adolescent mental health services in Stockholm, we identified 3,391 children, born 1984-1994, with neurodevelopmental disorders, and compared their risk for subsequent violent criminality with matched controls. Individuals with ADHD or TDs were at elevated risk of committing violent crimes, no such association could be seen for ASDs or OCD. ADHD and TDs are risk factors for subsequent violent criminality, while ASDs and OCD are not associated with violent criminality.
    Full-text · Article · Jun 2013 · Journal of Autism and Developmental Disorders
  • Source
    • "Attention deficit hyperactivity disorder (ADHD) and tic disorder are neurodevelopmental disorders that begin in childhood, and they frequently co-occur in the same individuals, although they have very diverse clinical symptoms: ADHD exhibits the inability to marshal and sustain attention and modulate the activity level, and tic disorder manifests bouts of sudden, rapid, and involuntary motor or phonic movements (Leckman, 2002; Rappley, 2005; Rothenberger, Roessner, Banaschewski, & Leckman, 2007). This coexistent effect is of clinical and scientific value, because the coexistence of tic disorder has an adverse impact on patients with ADHD (Greimel et al., 2011; Lin, Lai, & Gau, 2012). Furthermore , the co-occurrence of ADHD and tic disorder plays an important role in medication choice, because neurostimulants may exacerbate the symptoms of tic disorder in about 5–10% of ADHD patients (Roessner, Robatzek, Knapp, Banaschewski , & Rothenberger, 2006). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Attention deficit hyperactivity disorder (ADHD) and tic disorder usually co-occur in the same individuals, but the underlying mechanisms remain unclear. Previous evidence has shown that a frequent coexistence of allergic diseases was noted in patients with ADHD or tic disorder. We attempted to investigate the possible link among ADHD, tic disorder, and various allergic diseases. Methods: Utilizing the Taiwan National Health Insurance Research Database from 1996 to 2010, 5,811 patients with ADHD alone, 1,816 patients with tic disorder alone, and 349 patients with dual diagnoses of ADHD and tic disorder were identified and compared with age-/gender-matched controls (1:4) in an investigation of the association among ADHD, tic disorder, and allergic diseases. Results: Patients with dual diagnoses of ADHD and tic disorder had a significantly higher prevalence of allergic diseases and psychiatric comorbidities, including allergic rhinitis (43% vs. 28.4% vs. 33.6% vs. 19.7%, p < 0.001), asthma (27.5% vs. 17.2% vs. 18.2% vs. 11.9%, p < 0.001), atopic dermatitis (10.6% vs. 8.4% vs. 7.0 vs. 5.9%, p < 0.001), allergic conjunctivitis (55.6% vs. 34.7% vs. 43.5% vs. 26.3%, p < 0.001), obsessive compulsive disorder (4.0% vs. 1.3% vs. 2.0% vs. 0.1%, p < 0.001), and anxiety disorder (22.1% vs. 18.0% vs. 6.0% vs. 0.5%, p < 0.001) than the ADHD alone group, the tic alone group, and the control group. Furthermore, ADHD patients with more allergic diseases (≥3 comorbidities: OR: 3.73, 95% CI: 2.65∼5.25; 2 comorbidities: OR: 2.52, 95% CI: 1.82∼3.47; 1 comorbidity: OR: 1.87, 95% CI: 1.41∼2.49) exhibited an increased risk of tic disorder compared with ADHD patients without allergic disease. Conclusion: A significant association among ADHD, tic disorder, and allergic diseases was noted in our study. The results may inspire further studies to clarify the underlying mechanisms and help us understand more about the complex etiology of ADHD, tic disorder, and their co-occurrence.
    Full-text · Article · Nov 2012 · Journal of Child Psychology and Psychiatry
Show more