Comorbid Depressive Disorders in ADHD: The Role of ADHD Severity, Subtypes and Familial Psychiatric Disorders.
OBJECTIVE
To evaluate the presence of Major Depressive Disorder (MDD) and Dysthymic Disorder (DD) in a sample of Italian children with Attention Deficit Hyperactivity Disorder (ADHD) and to explore specific features of comorbid depressive disorders in ADHD.


METHODS
Three hundred and sixty-six consecutive, drug-naïve Caucasian Italian outpatients with ADHD were recruited and comorbid disorders were evaluated using DSM-IV-TR criteria. To evaluate ADHD severity, parents of all children filled out the ADHD Rating Scale. Thirty-seven children with comorbid MDD or DD were compared with 118 children with comorbid conduct disorder and 122 without comorbidity for age, sex, IQ level, family psychiatric history, and ADHD subtypes and severity.


RESULTS
42 of the ADHD children displayed comorbid depressive disorders: 16 exhibited MDD, 21 DD, and 5 both MDD and DD. The frequency of hyperactive-impulsive subtypes was significantly lower in ADHD children with depressive disorders, than in those without any comorbidity. ADHD children with depressive disorders showed a higher number of familial psychiatric disorders and higher score in the Inattentive scale of the ADHD Rating Scale, than children without any comorbidity. No differences were found for age, sex and IQ level between the three groups.


CONCLUSIONS
Consistent with previous studies in other countries, depressive disorders affect a significant proportion of ADHD children in Italy. Patient assessment and subsequent treatment should take into consideration the possible presence of this comorbidity, which could specifically increase the severity of ADHD attention problems.
Department of Dynamic and Clinical Psychology, University of Rome Sapienza, Rome, Italy.
Michela
M
Di Trani
U.O.N.P.I. Avezzano, L'Aquila, Italy.
Francesca
F
Di Roma
Humanitas-School of Cognitive Behavior Psychotherapy, Rome, Italy.
Elda
E
Andriola
Andriola
A
Elda
Istituto di Neuropsichiatria Infantile, Università Cattolica del Sacro Cuore, Rome, Italy.
Daniela
D
Leone
Leone
L
Daniela
DESMOS Department, Sant'Andrea Hospital, II Faculty of Medicine, University of Rome Sapienza, Rome, Italy.
Pasquale
P
Parisi
Parisi
P
Pasquale
DESMOS Department, Sant'Andrea Hospital, II Faculty of Medicine, University of Rome Sapienza, Rome, Italy.
Silvia
S
Miano
Miano
M
Silvia
Pertini Hospital ASL RM/B, Rome, Italy.
Renato
R
Donfrancesco
Donfrancesco
D
Renato
Attention deficit hyperactivity disorder; Comorbidity; Depressive disorder