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Attention-deficit/hyperactivity disorder and dissociative disorder among abused children

Taro Endo1, Toshiro Sugiyama, Toshiyuki Someya

  • 1Department of Psychiatry, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan. tarou@med.niigata-u.ac.jp

Psychiatry and Clinical Neurosciences
|August 4, 2006
PubMed

Insights

Child abuse (CA) can lead to psychiatric issues, including attention-deficit/hyperactivity disorder (ADHD). Dissociative disorders in abused children may mimic or increase apparent ADHD symptoms, complicating diagnosis.

Area of Science:

  • Child and Adolescent Psychiatry
  • Developmental Psychology
  • Trauma Studies

Background:

  • Child abuse (CA) is a significant risk factor for developing psychiatric problems.
  • Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, but its presentation in abused children requires further investigation.
  • The temporal relationship between CA and the onset of ADHD symptoms is not well-established.

Purpose of the Study:

  • To investigate psychiatric problems in children who have experienced child abuse (CA).
  • To determine if attention-deficit/hyperactivity disorder (ADHD) symptoms manifest before or after CA.
  • To explore the relationship between dissociative disorders and ADHD in abused children.

Main Methods:

  • Study included 39 inpatient children treated for child abuse (mean age 10.7 years).
  • Diagnostic criteria from DSM-IV-TR were used to assess for ADHD and dissociative disorders.
  • Data were analyzed to compare symptom onset and comorbidity rates.

Main Results:

  • Dissociative disorder was the most frequent diagnosis (59%) among abused children.
  • ADHD was diagnosed in 18% of subjects, with 71% having comorbid dissociative disorder.
  • 67% met ADHD criteria, but only 27% met them before CA; dissociative disorder cases more frequently met ADHD criteria, suggesting apparent ADHD.

Conclusions:

  • Abused children may present with increased apparent ADHD symptoms due to comorbid dissociative disorders.
  • Distinguishing between ADHD and dissociative disorder in this population is challenging.
  • Further research is needed to understand the biological differences between pre- and post-abuse ADHD presentations.

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