title: Impact of Comorbidity on Three Month Follow-up Outcome of Children with ADHD in a Child Guidance Clinic: Preliminary Report.
abstract: BACKGROUND
  Attention deficit hyperactivity disorder (ADHD) is one of the common neurodevelopmental disorders.
  
  
  OBJECTIVE
  Study objective is to report impact of comorbidities on short-term outcome in children with ADHD followed in a child guidance clinic.
  
  
  METHODS
  This was done in a child guidance clinic run jointly by the pediatric and psychiatry department at a tertiary teaching hospital. This is a 3 month prospective follow-up study to assess the outcome in ADHD children.
  
  
  METHODS
  Children attending pediatric department with behavioral problems or poor scholastic performance were screened for ADHD and further confirmation of diagnosis was done by semistructured interview of the child and parent. Children functional assessment and ADHD symptom profile was compared at baseline and at follow-up. We screened for and excluded those showing autistic spectrum disorder and having worse than mild mental retardation. Baseline variables were compared between improved and not improved subgroups and impact of these variables on outcome at 3-month follow-up was analyzed.
  
  
  METHODS
  Descriptive statistics.
  
  
  RESULTS
  Of the 25 children completing the study, at the end of 3 months, 15 improved (not fulfilling criteria for ADHD) and 10 did not improve. Applying Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) for diagnosis of psychiatric comorbidities, six had associated psychiatric comorbidities. This was significantly higher in those who did not improve.
  
  
  CONCLUSIONS
  Presence of comorbidities at baseline was found to affect outcome at 3 month assessment in this preliminary study. Future studies with larger sample and longer follow-up are needed for finding the predictors of outcome in ADHD children in developing nations.
authors.affiliation: Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
authors.forename: Rangan
authors.initials: R
authors.lastname: Srinivasaraghavan
authors.affiliation: Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
authors.forename: Subramanian
authors.initials: S
authors.lastname: Mahadevan
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
authors.forename: Shivanand
authors.initials: S
authors.lastname: Kattimani
keywords: Attention deficit disorder with hyperactivity; children; comorbidity; follow-up studies