Childhood ADHD is strongly associated with a broad range of psychiatric disorders during adolescence: a population‐based birth cohort study
Open accessAbstract
Background: To evaluate associations between attention‐deficit/hyperactivity disorder (ADHD) and comorbid psychiatric disorders using research‐identified incident cases of ADHD and population‐based controls. Methods: Subjects included a birth cohort of all children born 1976–1982 remaining in Rochester, MN after age five ( n = 5,718). Among them we identified 379 ADHD incident cases and 758 age‐gender matched non‐ADHD controls, passively followed to age 19 years. All psychiatric diagnoses were identified and abstracted, but only those confirmed by qualified medical professionals were included in the analysis. For each psychiatric disorder, cumulative incidence rates for subjects with and without ADHD were estimated using the Kaplan–Meier method. Corresponding hazard ratios (HR) were estimated using Cox models adjusted for gender and mother’s age and education at the subject’s birth. The association between ADHD and the likelihood of having an internalizing or externalizing disorder was summarized by estimating odds ratios (OR). Results: Attention‐deficit/hyperactivity disorder was associated with a significantly increased risk of adjustment disorders (HR = 3.88), conduct/oppositional defiant disorder (HR = 9.54), mood disorders (HR = 3.67), anxiety disorders (HR = 2.94), tic disorders (HR = 6.53), eating disorders (HR = 5.68), personality disorders (HR = 5.80), and substance‐related disorders (HR = 4.03). When psychiatric comorbidities were classified on the internalization‐externalization dimension, ADHD was strongly associated with coexisting internalizing/externalizing (OR = 10.6), or externalizing‐only (OR = 10.0) disorders. Conclusion: This population‐based study confirms that children with ADHD are at significantly increased risk for a wide range of psychiatric disorders. Besides treating the ADHD, clinicians should identify and provide appropriate treatment for psychiatric comorbidities.
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ADHD is strongly associated with emotional dysfunction, including internalizing symptoms (odds ratio 4.1), externalizing symptoms (odds ratio 10.0), or their combination (odds ratio 10.6).
“ADHD is highly associated with emotional dysfunction, expressed as internalizing (odds ratio= 4.1) and externalizing (odds ratio=10.0) symptoms or their combination (odds ratio=10.6) (Yoshimasu et al., 2012).”
From Data‐driven identification of subtypes of executive function across typical development, attention deficit hyperactivity disorder, and autism spectrum disorders (2020) · cites this paper as Yoshimasu et al., 2012
The Results report the three stated odds ratios: 4.1 for internalizing-only, 10.0 for externalizing-only, and 10.6 for combined disorders, each compared with no such disorder. The Methods describe these as categories of clinically identified psychiatric disorders, not measures of emotional dysfunction or symptom levels. (LLM, conf=0.83)
Experimental — accuracy not yet measuredPure ADHD is rare, and comorbidity is the rule in ADHD clinical samples.
“since 'pure' ADHD is rare, and comorbidity is the rule in ADHD clinical samples, with very few exceptions (Owens & Hinshaw, 2016;Yoshimasu et al., 2012)”
From Assessment of executive function in ADHD adolescents: contribution of performance tests and rating scales (2018) · cites this paper as Yoshimasu et al., 2012
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- Authors
- Yoshimasu, K., Barbaresi, W. J., Colligan, R. C., Voigt, R. G., Killian, J. M., Weaver, A. L., & Katusic, S. K.
- Affiliations
- Mayo Clinic (US)
- Boston Children's Hospital (US)
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2012-05-31
- Volume
- 53
- Issue
- 10
- Pages
- 1036-1043
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC3608464
- OpenAlex
- W1713729138
- Cited by
- 290
- References
- 12
- Citations by year
- 2026: 4 · 2025: 15 · 2024: 15 · 2023: 15 · 2022: 18 · 2021: 24 · 2020: 27 · 2019: 27 · 2018: 14 · 2017: 28 · 2016: 31 · 2015: 27 · 2014: 27 · 2013: 12 · 2012: 4
- FWCI
- 15.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Mayo Foundation for Medical Education and Research
- National Institutes of Health
- National Institute on Aging (R01AG034676, AG-034676)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD029745)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- attention deficit hyperactivity disorder, psychiatric comorbidity, adolescent mental disorders, internalizing disorders, externalizing disorders, conduct disorder, oppositional defiant disorder, mood disorders, anxiety disorders, tic disorders, eating disorders, personality disorders, substance-related disorders, adjustment disorder, cumulative incidence
- MeSH terms
- Adolescent, Adult, Feeding and Eating Disorders, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Female, Humans, Internal-External Control, Male, Minnesota, Personality Disorders, Tic Disorders, Cohort Studies, Comorbidity, Incidence, Proportional Hazards Models, Odds Ratio, Sex Distribution, Conduct Disorder, Mood Disorders, Substance-Related Disorders, Kaplan-Meier Estimate, Young Adult
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