Are perinatal complications relevant to the manifestation of ADD? Issues of comorbidity and familiality.
OBJECTIVE
We evaluated the role of pregnancy, delivery, and infancy complications (PDICs) in the etiology of attention deficit disorder (ADD) addressing issues of comorbidity and familiarity by formulating and testing multiple hypotheses.


METHODS
Subjects were six to 17-year-old boys with DSM-III attention deficit disorder (ADD, N = 73), psychiatric (N = 26), and normal (N = 26) controls and their relatives. Information on PDICs was obtained from the mothers in a standardized manner blind to the proband's clinical status.


RESULTS
Using odds ratio analyses, an association was found between ADD and PDICs that was strongest for the comorbid and nonfamilial subtypes. In contrast, noncomorbid and familial ADD subgroups differed less from normal controls in the risk for PDICs.


CONCLUSIONS
The increased risk for PDICs in nonfamilial ADD children and the lack of evidence for increased risk among familial ADD patients suggests that PDICs may be part of nongenetic etiologic mechanisms in this disorder, especially for children who have comorbid disorders.
Sprich-Buckminster
S
S
Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114.
Biederman
J
J
Milberger
S
S
Faraone
S V
SV
Lehman
B K
BK
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology; D001925:Brain Damage, Chronic / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012307:Risk Factors