ADHD

08 February 2011

ADHD kids have multiple conditions

Two-thirds of children with ADHD struggle with other mental health and developmental conditions, such as learning disabilities and anxiety, a new study suggests.

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Two-thirds of children with attention-deficit/hyperactivity disorder struggle with other mental health and developmental conditions, such as learning disabilities and anxiety, a new study suggests.

Examining data on nearly 62,000 US children aged six to 17 obtained from the 2007 National Survey of Children's Health, researchers found that those with ADHD had higher odds than others of repeating a grade at school and dealing with strained social and family relationships.

Notably, children from poor families were nearly four times as likely as affluent children to suffer from multiple conditions associated with ADHD, which also include conduct disorder, depression and speech problems, among others, the study said.

"This is a really striking finding that I don't think has been documented before," said study author Kandyce Larson, a research associate at the Center for Healthier Children, Families & Communities at the University of California, Los Angeles.

ADHD and other conditions

ADHD, a condition characterised by impulsiveness and difficulty staying focused, is one of the most common cognitive and behavioural disorders diagnosed in school-age children, according to the study reported online in the journal Pediatrics. It affects about 8% of US children, the study authors noted.

The data analysed by Larson and her team used detailed parent interviews to learn if a health-care provider had ever told them their child had ADHD. An "Aggravation in Parenting" scale measured parental stress by asking how often the child angered them and if the child was much more difficult to care for than others.

In total, 67% of youngsters with ADHD had at least one other reported mental health or neurodevelopmental disorder, compared with 11% of unaffected American children. Eighteen percent had three or more additional conditions, the study authors said.

Richard Milich, a professor of psychology at the University of Kentucky, praised the study for its large sample population but pointed out that all the data came from parental reporting, which he considers a limitation.

"Is this reality or parental perception? A dysfunctional mother may find a child multiply impaired because she may not be able to handle it," said Milich, who has studied ADHD for 35 years.

Milich noted that low-income children tend to have risk factors, such as suboptimal nutrition, that may explain why they struggle disproportionately with other conditions associated with ADHD.

"I'm not especially surprised that the more comorbidities they have, the worse the outcome is," he said. "It's extremely rare to see a kid with ADHD and nothing else."

While the study didn't address treatment interventions for ADHD-affected children, Larson said it suggests a large group is "slipping between the cracks of care."

"This really suggests we need to be doing more, to have more proactive treatment strategies and support for families," she said. "Treatment does need to be more individually tailored . . . and the findings show a need for greater integration of services between health, mental health and social services across sectors."


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ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation (www.gb4adhd.co.za) She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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