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Cited by 580Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentDevelopmental and Educational Neuropsychology

Patterns of Comorbidity, Functioning, and Service Use for US Children With ADHD, 2007

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Larson, Kandyce, Russ, Shirley A., Kahn, Robert S., Halfon, Neal·2011·Pediatrics
DOI 10.1542/peds.2010-0165PMC PMC3065146
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Abstract

OBJECTIVE: To determine patterns of comorbidity, functioning, and service use for US children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Bivariate and multivariable cross-sectional analyses were conducted on data from the 2007 National Survey of Children's Health on 61 779 children ages 6 to 17 years, including 5028 with ADHD. RESULTS: Parent-reported diagnosed prevalence of ADHD was 8.2%. Children with ADHD were more likely to have other mental health and neurodevelopmental conditions. Parents reported that 46% of children with ADHD had a learning disability versus 5% without ADHD, 27% vs 2% had a conduct disorder, 18% vs 2% anxiety, 14% vs 1% depression, and 12% vs 3% speech problems (all P < .05). Most children with ADHD had at least 1 comorbid disorder: 33% had 1, 16% had 2, and 18% had 3 or more. The risk for having 3 or more comorbidities was 3.8 times higher for poor versus affluent children (30% vs 8%). Children with ADHD had higher odds of activity restriction (odds ratio: 4.14 [95% confidence interval: 3.34–5.15]), school problems (odds ratio: 5.18 [95% confidence interval: 4.47–6.01]), grade repetition, and poor parent-child communication, whereas social competence scores were lower and parent aggravation higher. Functioning declined in a stepwise fashion with increasing numbers of comorbidities, and use of health and educational services and need for care coordination increased. CONCLUSIONS: Clinical management of ADHD must address multiple comorbid conditions and manage a range of adverse functional outcomes. Therapeutic approaches should be responsive to each child's neurodevelopmental profile, tailored to their unique social and family circumstances, and integrated with educational, mental health and social support services.

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  • Psychiatric comorbidities are known to be more common in patients with ADHD, particularly depression, anxiety, and bipolar disorder.

    “Psychiatric comorbidities are known to be more common in patients with ADHD, particularly depression, anxiety, and bipolar disorder[4-9,24].”

    From Attention deficit hyperactivity disorder and gastrointestinal morbidity in a large cohort of young adults (2020) · cites this paper as [6]

    The Abstract reports higher rates of anxiety (18% vs 2%) and depression (14% vs 1%) among children with ADHD, and the Conclusions describe a high prevalence of comorbidities in this group. Bipolar disorder is not among the conditions examined in the ADHD and Comorbid Disorders section, so this source does not support that part of the claim. Its findings also concern US children, rather than patients with ADHD generally. (LLM, conf=0.90)

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  • ADHD in adults can be associated with different challenges than in children and adolescents, such as higher prevalence of psychiatric comorbidities and functional impairment, potentially because of increasing life responsibilities and stressors.

    “However, ADHD in adults can be associated with different challenges than those in children and adolescents, such as higher prevalence of psychiatric comorbidities2,17 and functional impairment,7,18 potentially because of increasing life responsibilities and stressors.6,19”

    From Health care resource utilization and costs associated with psychiatric comorbidities in adult patients with attention-deficit/ hyperactivity disorder (2024) · cites this paper as [17]

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  • The association of ADHD to psychiatric comorbidity has been well described.

    “The association of ADHD to psychiatric comorbidity has been well described[4-9]”

    From Attention deficit hyperactivity disorder and gastrointestinal morbidity in a large cohort of young adults (2020) · cites this paper as [6]

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2 of the 74 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. Bloom B, Cohen RA, Freeman G. Summary health statistics for US children: National Health Interview Survey, 2007. National Cen- ter for Health Statistics. Vital Health Stat 10. 2009;239:1-80
  2. Angold A, Costello EJ, Erkanli A. Comorbidity. J Child Psychol Psychiatry. 1999;40(1): 57-87
  3. Daviss WB. A review of comorbid depression in pediatric ADHD: etiology, phenomenology, and treatment. J Child Adolesc Psychophar- macol. 2008;18(6):565-571
  4. Starfield B. Childhood morbidity: compari- sons, clusers, and trends. Pediatrics. 1991; 88(3):519 -526
  5. Starfield B, Robertson J, Riley A. Social class gradients and health in childhood. Ambul Pediatr. 2002;2(4):238 -246

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Authors
Larson, K., Russ, S. A., Kahn, R. S., & Halfon, N.
Affiliations
  • University of California, Los Angeles (US)
  • Cedars-Sinai Medical Center (US)
  • Cincinnati Children's Hospital Medical Center (US)
Corresponding author
Larson, Kandyce
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2011-03-01
Volume
127
Issue
3
Pages
462-470
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2010-0165
PMC
PMC3065146
OpenAlex
W2133663175
Cited by
580
References
74
Citations by year
2026: 16 · 2025: 30 · 2024: 27 · 2023: 39 · 2022: 42 · 2021: 43 · 2020: 47 · 2019: 51 · 2018: 46 · 2017: 39 · 2016: 45 · 2015: 48 · 2014: 37 · 2013: 34 · 2012: 23
FWCI
22.98
Type
journal article
Language
en
Open access
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • Health Resources and Services Administration
  • U.S. Public Health Service (2T76M600014:11)
  • Maternal and Child Health Bureau
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 › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords
attention deficit hyperactivity disorder, comorbidities, children, functioning, service utilization, learning disabilities, conduct disorder, anxiety, depression, speaking difficulties, socioeconomic status, school problems, school retention, parent-child communication, social competence, care coordination, National Survey of Children's Health
MeSH terms
Adolescent, Anxiety Disorders, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Cross-Sectional Studies, Humans, Learning Disabilities, Mental Health, Retrospective Studies, United States, Comorbidity, Prevalence, Delivery of Health Care, Integrated

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