Differentiating major depressive disorder in youths with attention deficit hyperactivity disorder.
BACKGROUND
Youths with attention deficit hyperactivity disorders (ADHD) frequently have comorbid major depressive disorders (MDD) sharing overlapping symptoms. Our objective was to examine which depressive symptoms best discriminate MDD among youths with ADHD.


METHODS
One-hundred-eleven youths with ADHD (5.2-17.8 years old) and their parents completed interviews with the K-SADS-PL and respective versions of the child or the parent Mood and Feelings Questionnaire (MFQ-C, MFQ-P). Controlling for group differences, logistic regression was used to calculate odds ratios reflecting the accuracy with which various depressive symptoms on the MFQ-C or MFQ-P discriminated MDD. Stepwise logistic regression then identified depressive symptoms that best discriminated the groups with and without MDD, using cross-validated misclassification rate as the criterion.


RESULTS
Symptoms that discriminated youths with MDD (n=18) from those without MDD (n=93) were 4 of 6 mood/anhedonia symptoms, all 14 depressed cognition symptoms, and only 3 of 11 physical/vegetative symptoms. Mild irritability, miserable/unhappy moods, and symptoms related to sleep, appetite, energy levels and concentration did not discriminate MDD. A stepwise logistic regression correctly classified 89% of the comorbid MDD subjects, with only age, anhedonia at school, thoughts about killing self, thoughts that bad things would happen, and talking more slowly remaining in the final model.


CONCLUSIONS
Results of this study may not generalize to community samples because subjects were drawn largely from a university-based outpatient psychiatric clinic.


CONCLUSIONS
These findings stress the importance of social withdrawal, anhedonia, depressive cognitions, suicidal thoughts, and psychomotor retardation when trying to identify MDD among ADHD youths.
Diler
Rasim Somer
RS
Division of Child Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, USA.
Daviss
W Burleson
WB
Lopez
Adriana
A
Axelson
David
D
Iyengar
Satish
S
Birmaher
Boris
B
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires