Comorbid Problems in ADHD: Degree of Association, Shared Endophenotypes, and Formation of Distinct Subtypes. Implications for a Future DSM
Open accessAbstract
We aimed to assess which comorbid problems (oppositional defiant behaviors, anxiety, autistic traits, motor coordination problems, and reading problems) were most associated with Attention-Deficit/Hyperactivity Disorder (ADHD); to determine whether these comorbid problems shared executive and motor problems on an endophenotype level with ADHD; and to determine whether executive functioning (EF)-and motor-endophenotypes supported the hypothesis that ADHD with comorbid problems is a qualitatively different phenotype than ADHD without comorbid problems. An EF-and a motor-endophenotype were formed based on nine neuropsychological tasks administered to 816 children from ADHD-and control-families. Additional data on comorbid problems were gathered using questionnaires. Results indicated that oppositional defiant behaviors appeared the most important comorbid problems of ADHD, followed by autistic traits, and than followed by motor coordination problems, anxiety, and reading problems. Both the EF-and motor-endophenotype were correlated and cross-correlated in siblings to autistic traits, motor coordination problems and reading problems, suggesting ADHD and these comorbid problems may possibly share familial/genetic EF and motor deficits. No such results were found for oppositional defiant behaviors and anxiety. ADHD in co-occurrence with comorbid problems may not be best seen as a distinct subtype of ADHD, but further research is warranted.
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The vast majority of people with ADHD, both child and adult, have a comorbid psychiatric disorder.
“The first challenge is related to the clinical complexity of the cases themselves; the vast majority of people with ADHD, both child and adult, have a comorbid psychiatric disorder [122-125].”
From Advances in understanding and treating ADHD (2011) · cites this paper as [124]
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- Authors
- Rommelse, N. N. J., Altink, M. E., Fliers, E. A., Martin, N. C., Buschgens, C. J. M., Hartman, C. A., Buitelaar, J. K., Faraone, S. V., Sergeant, J. A., & Oosterlaan, J.
- Affiliations
- Vrije Universiteit Amsterdam (NL)
- Radboud University Medical Center (NL)
- Curtin University (AU)
- University of Groningen (NL)
- SUNY Upstate Medical University (US)
- Corresponding author
- Rommelse, Nanda N. J.
- ORCID
- Venue
- Journal of Abnormal Child Psychology
- Published
- 2009-03-24
- Volume
- 37
- Issue
- 6
- Pages
- 793-804
- ISSN
- 0091-0627 (ISSN-L)
- 1573-2835
- PMC
- PMC2708322
- OpenAlex
- W2120286754
- Cited by
- 138
- References
- 62
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 6 · 2023: 3 · 2022: 2 · 2021: 8 · 2020: 5 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 6 · 2015: 10 · 2014: 18 · 2013: 10 · 2012: 13
- FWCI
- 10.48
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- National Institutes of Health
- U.S. Public Health Service (RR03655)
- National Institute of Mental Health (R01MH062873, R01 MH62873-01A1)
- National Center for Research Resources (RR-03655, P41RR003655)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- attention deficit hyperactivity disorder, comorbidities, endophenotypes, executive function, motor coordination deficits, oppositional defiant behavior, autistic traits, anxiety, reading difficulties, ADHD subtypes, children
- MeSH terms
- Adolescent, Anxiety Disorders, Attention Deficit Disorder with Hyperactivity, Autistic Disorder, Mental Disorders, Child, Child, Preschool, Dyslexia, Female, Humans, Male, Netherlands, Neuropsychological Tests, Phenotype, Psychomotor Disorders, Psychomotor Performance, Surveys and Questionnaires, Task Performance and Analysis, Comorbidity, Attention Deficit and Disruptive Behavior Disorders, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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