Personality comorbidity in adolescent females with ADHD

Attention-deficit/hyperactivity disorder (ADHD), a common disorder in adolescents, is associated with extensive comorbid Axis I psychopathology. However, few studies have addressed Axis I comorbidity in girls with ADHD, and even fewer have examined comorbid personality disorders in this population. This pilot study explored personality patterns in psychiatrically hospitalized adolescent females with ADHD.

Thirty-seven adolescent females were assessed for ADHD using the Diagnostic Interview for Children and Adolescents and assigned to groups based on the presence or absence of ADHD. The two groups (ADHD Group, n=10; No ADHD Group, n=27) were compared using the Structured Interview for DSM-III-R Personality Disorders to assess for coexisting Axis II disorders. Multiple information sources and clinical corroboration were used to arrive at "best estimate" diagnoses.

Subjects in the ADHD Group were found to have significantly more personality disorders than those in the No ADHD Group (4.5 versus 1.59 diagnoses/subject). Paranoid, histrionic, borderline, passive-aggressive, and dependent personality disorders were significantly more frequent in the ADHD group.

In this study, adolescent girls with ADHD were more likely to have personality disorders than those without ADHD. Since extensive personality comorbidity may prolong and complicate treatment, early and complete identification of these disorders will foster effective treatment planning.