Psychiatric Comorbidity in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder: Psychopathology According to Subtype

Abstract

It is well-known that more than 50% of attention-deficit hyperactivity disorder (ADHD) cases also have comorbid psychiatric disorders. We evaluated the comorbid psychopathology of Korean children and adolescents with ADHD using a standardized diagnostic instrument. The Korean Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL-K) was administered and completed in 105 patients who had been referred to the outpatient and inpatient clinics at the Samsung Medical Center from March 2004 to May 2005. All of the cases were diagnosed as ADHD according to DSM-IV criteria. We analyzed their clinical characteristics and psychiatric comorbidities, and assessed the correlation of any comorbidity with gender, age and ADHD subtype. Among our 105 participants, 70 (66.7%) subjects were diagnosed with combined-type ADHD, 22 (21.0%) were the predominantly inattentive type, only 1 (1.0%) was determined to have the predominantly hyperactive-impulsive type of ADHD, and 12 (11.4%) were classified as not otherwise specified (NOS) ADHD. Eighty (76.2%) subjects had at least one comorbid disorder such as oppositional defiant disorder (n = 53, 50.5%), anxiety disorders (n = 35, 33.3%) and affective disorders (n = 15, 14.3%). Our patients ranged in age from five to 16 years. Among the factors including gender, age, and ADHD subtype, ADHD subtype was the only one significant to comorbidity in our study. The results of this study suggest that psychiatric comorbidity in Korean children with ADHD is similar to the results of previous studies in western countries. Out of all the ADHD subtypes, the combined-type group had a significantly higher ratio of comorbid disorders and psychopathologies.

Psychiatric Features and Parenting Stress Profiles of Subtypes of Attention-Deficit/Hyperactivity Disorder: Results from a Clinically Referred Taiwanese Sample

“…26 A Korean study using systemic interview to investigate a clinicreferred sample of 105 ADHD children reported that 66.7% were of combined subtype, 21.0% were of the inattentive subtype, and only one subject (1.0%) was of the hyperactive-impulsive subtype. 27 In our surveyed sample of 182 clinic-referred ADHD children, 68.1% were of combined subtype and 31.8% were of the inattentive subtype. Hyperactive-impulsive subtype children were excluded from the study because none of their caregivers fulfilled the inclusion criteria.…”

Características sociodemográficas y trastornos mentales en niños y adolescentes de consulta externa psiquiátrica infantil de una clínica de Medellín

“…Esto coincide con otras investigaciones que han hallado hasta el 76,2% de al menos un trastorno comórbido en esta población. En general, la comorbilidad en niños y adolescentes puede explicarse porque es una población que tiene mayor vulnerabilidad bioló-gica y social, ya que es un periodo sensible del neurodesarrollo y porque los antecedentes familiares de trastorno mental y pertenecer a un estrato socioeconómico bajo aumentan el riesgo 5 .…”

“…De los niños remitidos a clínicas psiquiátricas, un 30-50% tiene TDAH 5,6 ; en Colombia, un estudio realizado en un servicio especializado de psiquiatría infantil halló que el 36% tenía este diagnóstico y una comorbilidad total del 94%, las más comunes con el TOD y con los trastornos depresivos 4 ; otra investigación hecha en escolares españoles encontró una comorbilidad total de TDAH del 71%; el 46% de los niños tenían trastorno de ansiedad; el 31%, trastornos de conducta y el 9%, trastornos del ánimo 7 .…”

Diagnostik und Therapie von Aufmerksamkeitsstörungen

“…Während im Grundschulalter bis zu 50% der betroffenen Kinder auch ein oppositionelles Verhalten, etwa 23% eine Angststörung [2,24] und gehäuft Schulschwierigkeiten zeigen, weisen Kinder mit Aufmerksamkeitsstörung zu 11% auch eine Dyskalkulie auf [21]. Im Jugendalter wird als komorbide Störung eine bipolare Erkrankung [23] genannt.…”