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Patterns of comorbidity associated with subtypes of attention-deficit/hyperactivity disorder among 6- to 12-year-old

R B Eiraldi1, T J Power, C M Nezu

  • 1University of Pennsylvania School of Medicine, Philadelphia 19104, USA. eiraldi@mail.med.upenn.edu

Journal of the American Academy of Child and Adolescent Psychiatry
|April 1, 1997
PubMed

Insights

Children with combined subtype ADHD show higher externalizing problems and comorbidity with oppositional defiant disorder and conduct disorder. Internalizing problems were similar across ADHD subtypes and higher than in controls.

Area of Science:

  • Child and Adolescent Psychiatry
  • Neurodevelopmental Disorders
  • Behavioral Science

Background:

  • Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
  • ADHD presents with distinct subtypes: combined and inattentive.
  • Comorbidity patterns, particularly externalizing and internalizing problems, require further investigation in relation to ADHD subtypes.

Purpose of the Study:

  • To investigate and compare externalizing and internalizing comorbidity patterns in children diagnosed with ADHD combined subtype, ADHD inattentive subtype, and a typically developing control group.
  • To examine the diagnostic criteria (DSM-IV) and behavioral ratings for ADHD subtypes and their associated comorbidities.
  • To identify specific comorbidity profiles for different ADHD presentations in children aged 6-12 years.

Main Methods:

  • Participants included children aged 6-12 years, categorized into ADHD combined subtype (n=27), ADHD inattentive subtype (n=26), and a control group (n=33).
  • Group assignment was based on parent structured interviews (DSM-IV criteria) and teacher ADHD symptom ratings.
  • Comorbidities were assessed using parent/child structured interviews and parent/teacher behavior ratings.

Main Results:

  • Children with ADHD combined subtype exhibited significantly higher rates of oppositional defiant disorder and conduct disorder compared to ADHD inattentive and control groups.
  • Externalizing problem scores were significantly higher in the ADHD combined group based on parent and teacher ratings.
  • Both ADHD combined and inattentive subtypes showed significantly higher internalizing problem scores than the control group, with no significant differences between the ADHD subtypes themselves.

Conclusions:

  • A significant comorbidity exists between the combined subtype of ADHD and oppositional defiant disorder/conduct disorder.
  • Unlike studies using prior diagnostic criteria (DSM-III), this research found no significant differences in internalizing disorders between ADHD combined and inattentive subtypes.
  • Findings highlight distinct externalizing comorbidity profiles for ADHD combined subtype, emphasizing the need for subtype-specific interventions.
Abstract

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