title: Irritability in ADHD: Associations with depression liability.
abstract: Irritability and the new DSM-5 diagnostic category of Disruptive Mood Dysregulation Disorder (DMDD) have been conceptualised as related to mood disorder. Irritability is common in Attention Deficit Hyperactivity Disorder (ADHD) but little is known about its association with depression risk in this group. This study aims to establish levels of irritability and prevalence of DMDD in a clinical sample of children with ADHD, and examine their association with anxiety, depression and family history of depression.
  
  
  
  The sample consisted of 696 children (mean age 10.9 years) with a diagnosis of ADHD, recruited from UK child psychiatry and paediatric clinics. Parents completed the Child and Adolescent Psychiatric Assessment, a semi-structured diagnostic interview, about their child. This was used to establish prevalence of DMDD, anxiety disorder and depressive disorder, as well as obtain symptom scores for irritability, anxiety and depression. Questionnaires assessed current parental depression, and family history of depression.
  
  
  
  Irritability was common, with 91% endorsing at least one irritable symptom. 3-month DMDD prevalence was 31%. Children with higher levels of irritability or DMDD were more likely to have comorbid symptoms of anxiety, depression and a family history of depression.
  
  
  
  Results are based on a clinical sample, so may not be generalizable to children with ADHD in the general population.
  
  
  
  Irritability and DMDD were common, and were associated with markers of depression liability. Longitudinal studies are needed to examine the association between irritability and depression in youth with ADHD as they get older.
authors.affiliation: MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK. Electronic address: eyreo2@cardiff.ac.uk.
authors.forename: Olga
authors.initials: O
authors.lastname: Eyre
authors.affiliation: MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK; School of Psychology, Cardiff University, Wales, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Langley
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
authors.forename: Argyris
authors.initials: A
authors.lastname: Stringaris
authors.affiliation: Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Leibenluft
authors.affiliation: MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK.
authors.forename: Stephan
authors.initials: S
authors.lastname: Collishaw
authors.affiliation: MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK.
authors.forename: Anita
authors.initials: A
authors.lastname: Thapar
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001007:Anxiety / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D005190:Family; D005260:Female; D006801:Humans; D007508:Irritable Mood; D008137:Longitudinal Studies; D008297:Male; D019964:Mood Disorders / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D009483:Neuropsychological Tests; D010290:Parents; D015995:Prevalence; D012737:Sex Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: ADHD; DMDD; Depression; Irritability