This is kind of a data dump, but……
Two-thirds of U.S. children with attention deficit/hyperactivity disorder have comorbid learning disorders or other mental health or neurodevelopmental conditions, a national children’s health survey health found.
The survey, which included more than 5,000 children with ADHD, found that:
- 33% had one comorbid disorder,
- 16% had two, and
- 18% had three or more
School and social problems, along with poor communication with parents, were significantly associated with ADHD as well…
Although many physicians already screen for common comorbidities among children with ADHD, few are adequately trained to treat such co-occurrence, Larson’s group noted.
ADHD prevalence was 8.2%, according to parental report of physician diagnosis. This would correlate to more than 4 million cases nationwide, the researchers projected.
Prevalence was higher among children in lower income families and those headed by single mothers.
Overall, 67% of ADHD children had at least one other mental health or neurodevelopmental disorder compared with 11% in other children.
ADHD was associated with a substantially elevated prevalence of the following (all P<0.05):
- Learning disabilities (46% versus 5% in other children, adjusted relative risk 7.79)
- Conduct disorder (27% versus 2%, adjusted RR 12.58)
- Anxiety (18% versus 2%, adjusted RR 7.45)
- Depression (14% versus 1%, adjusted RR 8.04)
- Speech problems (12% versus 3%, adjusted RR 4.42)
Comorbidities didn’t vary by age or gender, but poor children with ADHD were 3.8 times more likely to have three or more comorbidities than the most affluent (30% versus 8%). Over-diagnosis was unlikely to be the cause of this socioeconomic link, according to the researchers. Rather, there may be common etiologic factors, like maternal stress or prenatal smoke exposure or genetic susceptibility, that are more prevalent in lower income families, they suggested.
Every measure of functioning showed a disadvantage with ADHD, including higher odds of the following:
- Activity restriction (adjusted odds ratio 4.14)
- School problems (69% versus 27%, adjusted OR 5.18)
- Grade repetition (29% versus 9%, adjusted OR 3.71)
- High parent aggravation scores (53% versus 19%, adjusted OR 4.30)
- Low social competence scores (43% versus 18%, adjusted OR 2.86)
- Poor parent-child communication (8% versus 3%, adjusted OR 2.55)
Poorer functioning increased with each step-wise increase in the number of comorbidities, as did use of mental health and education services.
The high rate of grade repetition and school problems “indicates that existing management strategies are falling short of meeting the needs of these children,” Larson’s group wrote in the paper.
They cautioned that the study was limited by use of parent reports and cross-sectional data, and the report did not address medication use or specific behavioral interventions.