Co-transmission of conduct problems with attention-deficit/hyperactivity disorder: familial evidence for a distinct disorder
Open accessAbstract
Common disorders of childhood and adolescence are attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD). For one to two cases in three diagnosed with ADHD the disorders may be comorbid. However, whether comorbid conduct problems (CP) represents a separate disorder or a severe form of ADHD remains controversial. We investigated familial recurrence patterns of the pure or comorbid condition in families with at least two children and one definite case of DSM-IV ADHDct (combined-type) as part of the International Multicentre ADHD Genetics Study (IMAGE). Using case diagnoses (PACS, parental account) and symptom ratings (Parent/Teacher Strengths and Difficulties [SDQ], and Conners Questionnaires [CPTRS]) we studied 1009 cases (241 with ADHDonly and 768 with ADHD + CP), and their 1591 siblings. CP was defined as > or =4 on the SDQ conduct-subscale, and T > or = 65, on Conners' oppositional-score. Multinomial logistic regression was used to ascertain recurrence risks of the pure and comorbid conditions in the siblings as predicted by the status of the cases. There was a higher relative risk to develop ADHD + CP for siblings of cases with ADHD + CP (RRR = 4.9; 95%CI: 2.59-9.41); p < 0.001) than with ADHDonly. Rates of ADHDonly in siblings of cases with ADHD + CP were lower but significant (RRR = 2.9; 95%CI: 1.6-5.3, p < 0.001). Children with ADHD + CP scored higher on the Conners ADHDct symptom-scales than those with ADHDonly. Our finding that ADHD + CP can represent a familial distinct subtype possibly with a distinct genetic etiology is consistent with a high risk for cosegregation. Further, ADHD + CP can be a more severe disorder than ADHDonly with symptoms stable from childhood through adolescence. The findings provide partial support for the ICD-10 distinction between hyperkinetic disorder (F90.0) and hyperkinetic conduct disorder (F90.1).
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Family and twin studies have demonstrated that genetic influences are shared between ADHD and a wide range of other neurodevelopmental and psychopathological traits and disorders, including conduct disorder and problems, cognitive performance, autism spectrum disorders and mood disorders.
“Family and twin studies have also demonstrated that genetic influences are shared between ADHD and a wide range of other neurodevelopmental and psycho pathological traits and disorders, including conduct disorder and problems 32 , cognitive performance 33 , autism s pectrum disorders 34 and mood disorders 35,36 .”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [32]
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- Authors
- Christiansen, H., Chen, W., Oades, R. D., Asherson, P., Taylor, E. A., Lasky-Su, J., Zhou, K., Banaschewski, T., Buschgens, C., Franke, B., Gabriels, I., Manor, I., Marco, R., Müller, U. C., Mulligan, A., Psychogiou, L., Rommelse, N. N. J., Uebel, H., Buitelaar, J., Ebstein, R. P., Eisenberg, J., Gill, M., Miranda, A., Mulas, F., Roeyers, H., Rothenberger, A., Sergeant, J. A., Sonuga-Barke, E. J. S., Steinhausen, H.-C., Thompson, M., & Faraone, S. V.
- Affiliations
- University of Duisburg-Essen (DE)
- University of Southampton (GB)
- SUNY Upstate Medical University (US)
- Central Institute of Mental Health (DE)
- Radboud University Nijmegen (NL)
- Geha Mental Health Center (IL)
- Universitat de València (ES)
- University of Zurich (CH)
- Trinity College Dublin (IE)
- Vrije Universiteit Amsterdam (NL)
- University of Göttingen (DE)
- Hebrew University of Jerusalem (IL)
- Ghent University (BE)
- Corresponding author
- Oades, R. D.
- ORCID
- Venue
- Journal of Neural Transmission
- Published
- 2008-01-16
- Volume
- 115
- Issue
- 2
- Pages
- 163-175
- ISSN
- 0300-9564 (ISSN-L)
- 1435-1463
- OpenAlex
- W2162416274
- Cited by
- 79
- References
- 61
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 6 · 2016: 3 · 2015: 7 · 2014: 3 · 2013: 8 · 2012: 1
- FWCI
- 7.21
- Type
- journal article
- Language
- en
- Open access
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Neural Transmission (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- DuEPublico (University of Duisburg-Essen) (submittedVersion)
- VU Research Portal (submittedVersion, other-oa)
- UWA Profiles and Research Repository (University of Western Australia) (submittedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- GoeScholar The Publication Server of the Georg-August-Universität Göttingen (Georg-August-Universität Göttingen) (submittedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- University of Southampton
- Medical Research Council
- Economic and Social Research Council
- National Institute of Mental Health (R01MH062873)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder, comorbidities, familial recurrence, siblings, ICD-10, hyperkinetic disorder, genetic etiology, symptom severity
- MeSH terms
- Adolescent, Age Factors, Attention Deficit Disorder with Hyperactivity, Child, Family Health, Female, Humans, Male, Psychometrics, Severity of Illness Index, Reproducibility of Results, Comorbidity, Multivariate Analysis, Conduct Disorder
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