P01-306-Adhd, gender, and psychiatric comorbidity in a populaiton-based birth cohort

Abstract

INTRODUCTIONADHD is frequently associated with comorbid psychiatric disorders. However, epidemiologic studies in the general population are rare.OBJECTIVETo evaluate associations between ADHD and comorbid psychiatric disorders using research-identified incident ADHD cases and population-based controls.METHODSubjects included a birth cohort of all children born 1976-1982 remaining in Rochester, MN after age five (n=5718). Among them we identified 379 ADHD incident cases and 758 age-sex matched non-ADHD controls, passively followed to age 19. Through a systematic, multistaged process, utilizing detailed, routinely collected data, all psychiatric diagnoses confirmed by medical professionals were identified (n=314 ADHD cases, n=712 controls with research authorization). For each psychiatric disorder, cumulative incidence rates for subjects with and without ADHD were calculated; corresponding hazard ratios (HR) adjusted for sex, mothers age/education, were estimated using a Cox model. Associations between ADHD status and Internalizing-Externalizing dimensions were estimated using odds ratios (OR).RESULTSADHD was associated with significantly increased risk for adjustment disorders (HR=3.82), conduct disorder/oppositional defiant disorder (HR=9.45), mood disorders (HR=3.57), anxiety disorders (HR=2.95), tic disorders (HR=6.41), eating disorders (HR=5.52), personality disorders (HR=5.49), and substance-related disorders (HR=4.04). When psychiatric comorbidities were classified on the Internalizing-Externalizing dimension, ADHD was strongly associated with coexisting internalizing/externalizing (OR=10.6, vs none), and externalizing-only (OR=10.0), disorders. No significant gender x ADHD interactions were observed.CONCLUSIONThis population-based study confirms that children with ADHD are at significant risk for co-morbid psychiatric disorders. Besides treating the ADHD, clinicians should assess and monitor potential psychiatric comorbidities in children with ADHD.