title: Attention deficit hyperactivity disorder characteristics: II. Clinical correlates of irritable mood.
abstract: BACKGROUND
  This study describes the relationship of irritable mood (IRR) with affective disorders in youths with attention deficit hyperactivity disorder (ADHD).
  
  
  METHODS
  Five hundred ADHD subjects were assessed with the childhood version of the Schedule for Affective Disorder & Schizophrenia. Subjects were in a genetic ADHD protocol and limited to those of Caucasian/European descent.
  
  
  RESULTS
  The most prevalent concurrent diagnoses were oppositional defiant disorder (ODD) (43.6%), minor depression/dysthymic disorder (MDDD) (18.8%), and generalized anxiety (13.2%)/overanxious disorder (12.4%). IRR subjects (21.0%) compared to the non-IRR (NIRR) group had higher rates of all affective disorders (76.2% vs. 9.6%) and ODD (83.8% vs. 32.9%) but lower rates of hyperactive ADHD (1.9% vs. 8.9%). Among those without comorbidities, 98.3% were NIRR. Logistic regression found IRR mood significantly associated with major depressive disorder (odds ratio [OR]: 33.4), MDDD (OR: 11.2), ODD (OR: 11.6), and combined ADHD (OR: 1.7) but not with anxiety disorders. Among symptoms, it associated IRR mood with a pattern of dysthymic and ODD symptoms but with fewer separation anxiety symptoms. Diagnostic and symptomatic parameters were unaffected by demographic variables.
  
  
  CONCLUSIONS
  Potential confounders influencing these results include patient recruitment from only one clinical service; a cohort specific sample effect because some presumed affective disorders and non-Caucasians were excluded; and the young mean age (10.2 years) limiting comorbid patterns.
  
  
  CONCLUSIONS
  The prominence of an MDDD pattern suggests this IRR group is appropriate in the DSM V's proposed chronic depressive disorder, possibly with or without temper dysregulation. A new diagnosis of disruptive mood dysregulation disorder may be unwarranted.
authors.affiliation: Division of Child & Adolescent Psychiatry, Drexel University College of Medicine, Philadelphia, PA 19124, USA. paul.ambrosini@drexelmed.edu
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Ambrosini
authors.forename: David S
authors.initials: DS
authors.lastname: Bennett
authors.forename: Josephine
authors.initials: J
authors.lastname: Elia
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000150:complications; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications*; D002648:Child; D002653:Child Behavior Disorders / Q000150:complications; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications*; D003865:Major Depressive Disorder / Q000150:complications; D019263:Dysthymic Disorder / Q000150:complications; D005260:Female; D006801:Humans; D007508:Irritable Mood; D008297:Male; D016017:Odds Ratio; D012044:Regression Analysis