The presentation of depression symptoms in attention‐deficit/hyperactivity disorder: comparing child and parent reports

Abstract

BackgroundAttention‐deficit/hyperactivity disorder (ADHD) frequently co‐occurs with depression, and outcomes are poor when both are present. Little is known about whether depression symptoms present differently in ADHD compared to the general population, or how reliable young people with ADHD are at reporting these symptoms. This study aimed to describe depression symptoms in a clinical ADHD sample compared to a population sample, and compare self‐reports of depression symptoms with parent‐reports.MethodsTwo hundred and forty‐nine children with ADHD and their parents completed follow‐up questionnaires around 5 years after taking part in a Cardiff University ADHD study. Child depression symptoms were measured using parent‐ and child‐reported Mood and Feelings Questionnaires (MFQ) and compared to a population sample with MFQ data (n = 1460). Within both samples, child‐ and parent‐reported depression symptoms were compared.ResultsAlthough the profile of depression symptoms was similar between young people with ADHD and those in the general population, depression symptoms were much more common in the ADHD sample (parent‐rated MFQ score = 24.52 vs. 9.39; child‐rated = 21.02 vs. 11.86). The most common symptoms in both samples included irritability, restlessness and concentration difficulties, with core depression symptoms such as feeling miserable/unhappy also prominent. Within the ADHD sample, but not the population sample, children reported depression symptoms less frequently than their parents.ConclusionsYoung people with ADHD are at high risk of experiencing symptoms of depression but may under‐report the severity of their symptoms. Obtaining parent reports of depression symptoms in this group may be important to avoid missing key indicators of risk.

Characterizing Developmental Trajectories and the Role of Neuropsychiatric Genetic Risk Variants in Early-Onset Depression

“… 24 , 48 , 74 Second, while it is generally accepted that self-reports of adolescent mood (as used in the present study) are reliable, children with neurodevelopmental disorders, predominately boys, may underreport their mood symptoms compared with typically developing children. 75 This reporting difference raises the possibility that the reliance on self-reported mood necessary in the present study due to repeated longitudinal assessments (see below) may mean that some individuals at high neurodevelopmental risk may have been misclassified. Finally, PRSs alone are unlikely to be able to reliably classify children’s risk of developing different types of depression trajectories.…”

What explains the link between childhood ADHD and adolescent depression? Investigating the role of peer relationships and academic attainment

“…As ADHD and depression share genetic liability [60,61], shared genetic liability with the mediators cannot be ruled out as an explanation of results. Also of note is the observation that young people with ADHD have been found to under-report their depressive symptoms [62], which may lead to an underestimation of associations.…”

Relational impairments, sluggish cognitive tempo, and severe inattention are associated with elevated self-rated depressive symptoms in adolescents with ADHD

“…Future longitudinal work will be informative for elucidating whether the onset of depression symptoms leads to subsequent reduction in HI for youth with ADHD relative to non-depressed ADHD youth. In addition, such research will be well-poised to address questions regarding potential biases in parent versus self-report of depressive symptoms in ADHD, which may vary from previously observed biases regarding self-report of ADHD symptoms (e.g., Fischer et al 1993; Fraser et al 2018; Sibley et al 2012a, b).…”