title: ADHD and Psychiatric Comorbidity: Functional Outcomes in a School-Based Sample of Children.
abstract: Objective:Investigate the prevalence and impact of psychiatric comorbidities in community-based samples of schoolchildren with/without ADHD.Method:Teachers and parents screened children in South Carolina (SC;n= 4,604) and Oklahoma (OK;n= 12,626) for ADHD. Parents of high-screen and selected low-screen children received diagnostic interviews (SC:n= 479; OK:n= 577).Results:Psychiatric disorders were increased among children with ADHD and were associated with low academic performance. Conduct disorder/oppositional defiant disorder (CD/ODD) were associated with grade retention (ODD/CD + ADHD: odds ratio [OR] = 3.0; confidence interval [CI] = [1.5, 5.9]; ODD/CD without ADHD: OR = 4.0; CI = [1.7, 9.7]). School discipline/police involvement was associated with ADHD alone (OR = 3.2; CI = [1.5, 6.8]), ADHD + CD/ODD (OR = 14.1, CI = [7.3, 27.1]), ADHD + anxiety/depression (OR = 4.8, CI = [1.6, 14.8]), and CD/ODD alone (OR = 2.8, CI = [1.2, 6.4]). Children with ADHD + anxiety/depression had tenfold risk for poor academic performance (OR = 10.8; CI = [2.4, 49.1]) compared to children with ADHD alone. This should be interpreted with caution due to the wide confidence interval.Conclusion:Most children with ADHD have psychiatric comorbidities, which worsens functional outcomes. The pattern of outcomes varies by type of comorbidity.
authors.affiliation: University of Florida College of Medicine, Jacksonville, USA.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Cuffe
authors.affiliation: Centers for Disease Control and Prevention (CDC), National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, Atlanta, GA, USA.
authors.forename: Susanna N
authors.initials: SN
authors.lastname: Visser
authors.affiliation: Centers for Disease Control and Prevention (CDC), National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, Atlanta, GA, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Holbrook
authors.affiliation: Centers for Disease Control and Prevention (CDC), National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, Atlanta, GA, USA.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Danielson
authors.affiliation: University of North Carolina, Chapel Hill, USA.
authors.forename: Lorie L
authors.initials: LL
authors.lastname: Geryk
authors.affiliation: University of Oklahoma Health Sciences Center, USA.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Wolraich
authors.affiliation: University of South Carolina, Columbia, SC, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: McKeown
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders; D002648:Child; D015897:Comorbidity; D019955:Conduct Disorder / Q000453:epidemiology; D006801:Humans; D009825:Oklahoma; D012574:Schools; D013022:South Carolina / Q000453:epidemiology
keywords: ADHD; ADHD impairment; community sample; comorbid psychopathology