title: Adaptive, emotional, and family functioning of children with obsessive-compulsive disorder and comorbid attention deficit hyperactivity disorder.
abstract: OBJECTIVE
  The purpose of the study was to examine adaptive, emotional, and family functioning in a well-characterized group of children and adolescents with obsessive-compulsive disorder (OCD) and to evaluate the influence of comorbid attention deficit hyperactivity disorder (ADHD) on the levels of impairment in various functional domains.
  
  
  METHODS
  The study group included 287 children and adolescents (191 boys, 96 girls) ages 7-18 years. Fifty-six subjects had a diagnosis of OCD only, 43 had both OCD and ADHD, 95 had ADHD, and 93 were unaffected comparison children. Best estimate DSM-IV diagnoses were assigned on the basis of structured interviews and clinical ratings. The children's functioning was evaluated with a comprehensive battery of well-established, standardized measures, including the Vineland Adaptive Behavior Scales, parents' ratings of social and family functioning, and children's self-reports of emotional adjustment.
  
  
  RESULTS
  The children with OCD only were more impaired than were unaffected comparison subjects in most areas of adaptive functioning and emotional adjustment. Children with OCD plus ADHD had additional difficulties in social functioning, school problems, and self-reported depression. Impairment in daily living skills, reduced number of activities, and self-reported anxiety were uniquely associated with the diagnosis of OCD. Family dysfunction was associated with ADHD but not with OCD.
  
  
  CONCLUSIONS
  Children and adolescents with OCD are impaired in multiple domains of adaptive and emotional functioning. When comorbid ADHD is present, there is an additional burden on social, school, and family functioning.
authors.affiliation: Child Study Center, Yale University School of Medicine, New Haven, CT 06520-7900, USA. denis.sukhodolsky@yale.edu
authors.forename: Denis G
authors.initials: DG
authors.lastname: Sukhodolsky
authors.forename: Maria C
authors.initials: MC
authors.lastname: do Rosario-Campos
authors.forename: Lawrence
authors.initials: L
authors.lastname: Scahill
authors.forename: Lily
authors.initials: L
authors.lastname: Katsovich
authors.forename: David L
authors.initials: DL
authors.lastname: Pauls
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Peterson
authors.forename: Robert A
authors.initials: RA
authors.lastname: King
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Lombroso
authors.forename: Diane B
authors.initials: DB
authors.lastname: Findley
authors.forename: James F
authors.initials: JF
authors.lastname: Leckman
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004644:Emotions; D005192:Family Health; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires