Symptom profiles in children with ADHD: effects of comorbidity and gender.
OBJECTIVE
To examine ratings and objective measures of attention-deficit/hyperactivity disorder (ADHD) symptoms to assess whether ADHD children with and without comorbid conditions have equally high levels of core symptoms and whether symptom profiles differ as a function of comorbidity and gender.


METHODS
Four hundred ninety-eight children from the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA) were divided into comorbid groups based on the parent Diagnostic Interview Schedule for Children and assessed via parents' and teachers' Swanson, Nolan, and Pelham (SNAP) ratings and a continuous performance test (CPT). Comorbidity and gender effects were examined using analyses of covariance controlled for age and site.


RESULTS
CPT inattention, impulsivity, and dyscontrol errors were high in all ADHD groups. Children with ADHD + oppositional defiant or conduct disorder were rated as more impulsive than inattentive, while children with ADHD + anxiety disorders (ANX) were relatively more inattentive than impulsive. Girls were less impaired than boys on most ratings and several CPT indices, particularly impulsivity, and girls with ADHD + ANX made fewer CPT impulsivity errors than girls with ADHD-only.


CONCLUSIONS
Children with ADHD have high levels of core symptoms as measured by rating scales and CPT, irrespective of comorbidity. However, there are important differences in symptomatology as a function of comorbidity and gender.
Newcorn
J H
JH
Department of Psychiatry, Mount Sinai School of Medicine, USA. Jeffrey.Newcorn@mssm.edu
Halperin
J M
JM
Jensen
P S
PS
Abikoff
H B
HB
Arnold
L E
LE
Cantwell
D P
DP
Conners
C K
CK
Elliott
G R
GR
Epstein
J N
JN
Greenhill
L L
LL
Hechtman
L
L
Hinshaw
S P
SP
Hoza
B
B
Kraemer
H C
HC
Pelham
W E
WE
Severe
J B
JB
Swanson
J M
JM
Wells
K C
KC
Wigal
T
T
Vitiello
B
B
D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000453:epidemiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D019955:Conduct Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009656:North America / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors