Psychiatric Comorbidities in 7-12 Year Old Children Diagnosed With ADHD in South Africa: A Record Review

Abstract

Background: ADHD is a prevalent neurodevelopmental disorder frequently accompanied by psychiatric comorbidities. While international evidence is well-established, data from South Africa — particularly in younger children — remain limited. Aim: To describe psychiatric comorbidities and associated factors in children aged 7–12 years with primary ADHD at the Child, Adolescent, and Family Unit (CAFU), Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Methods: A retrospective cross-sectional record review of children aged 7–12 years with primary ADHD at CAFU between January 2020 and December 2022. Data were analysed using SPSS version 26. Results: Of 573 records screened, 108 were included. The combined subtype was most prevalent (72.2%). Almost all children (95.5%) had at least one comorbidity. The most frequent were generalised anxiety disorder (52.8%), intellectual disability (38.9%), and oppositional defiant disorder (29.6%). Females were more likely to present with oppositional defiant disorder (p = .007) and males with autism spectrum disorder (p = .032). High rates of domestic violence (29.6%), parental substance abuse (33.3%), and parental psychiatric history (30.6%) were documented. Conclusion: Psychiatric comorbidities are highly prevalent in South African children with ADHD, exceeding international estimates, and reflect the broader psychosocial context of the setting. Comprehensive, multidisciplinary, and trauma-informed assessments are essential.