ADHD and Co-occurring Conditions
CHILDREN
The 2007 National Survey of Children’s Health (NCSH) found that 33% of the children with ADHD had one coexisting condition, 16% had two, and 18% had three or more (Larson 2011):
ADHD and Coexisting Conditions
| Learning Disability | 45% | 5% |
| Conduct Disorder | 27% | 2% |
| Anxiety | 18% | 2% |
| Depression | 15% | 1% |
| Speech Problems | 12% | 3% |
These are the most common co-occurring conditions in children and adolescents according to a study by Elia et al. (2008):
- Oppositional Defiance Disorder (ODD) was most common, appearing 41% of the time.
- Minor Depression/Dysthymia (MDDD) was second, with a rate of 22%.
- Generalized Anxiety Disorder (GAD) was third, appearing 15% of the time.
By ADHD Subtypes
| Oppositional Defiance Disorder (ODD) | 21% | 42% | 50.7% |
| Minor Depression/ Dysthymia (MDDD) | 21% | 21% | 21.7% |
| Generalized Anxiety Disorder (GAD) | 19% | 19% | 12.4% |
Learning & Writing Disabilities
31% to 45% of children with ADHD have a learning disability, and vice versa (DuPaul 2013).
“It is estimated that as many as one-third of those with LD also have ADHD” (NCLD 2014).
Boys with ADHD have about a 65% risk of having writing disabilities, compared to 16.5% of boys without ADHD, while girls with ADHD have a 57% risk compared to a 9.4% risk for girls without ADHD (Yoshimasu 2011).
Heart Disease
ADHD appears to be more prevalent in children with heart disease. A study by Kraut et al. (2013) examined 13,460 children using ADHD medication and found that 2% had a preexisting heart disorder compared with 1.2% of children not using medication.
ADULTS
The prevalence of coexisting conditions found by the National Comorbidity Survey Replication (NCS-R) in 3,199 adults with ADHD (ages 18-44) is as follows (Kessler et al. 2006):
| Any mood disorder | 38.3% | 11.1% |
| Major depressive disorder | 18.6% | 7.8% |
| Dysthymia (mild, chronic depression) | 12.3% | 1.9% |
| Bipolar disorder | 19.4% | 3.1% |
| Any anxiety disorder | 47.1% | 19.5% |
| Generalized anxiety disorder | 8.0% | 2.6% |
| PTSD | 11.9% | 3.3% |
| Panic disorder | 8.9% | 3.1% |
| Agoraphobia | 4.0% | 0.7% |
| Specific phobia | 22.7% | 9.5% |
| Social phobia | 29.3% | 7.8% |
| Obsessive-compulsive disorder (OCD) | 2.7% | 1.3% |
| Any substance abuse disorder | 15.2% | 5.6% |
| Alcohol abuse | 5.9% | 2.4% |
| Alcohol dependence | 5.8% | 2.0% |
| Drug abuse | 2.4% | 1.4% |
| Drug dependence | 4.4% | 0.6% |
| Intermittent explosive disorder | 19.6% | 6.1% |
Obesity
Obesity prevalence increases by about 70% in adults with ADHD compared to adults without ADHD. In children with ADHD, obesity prevalence increases by about 40% when compared to children without ADHD (Cortese, 2015).
Analysis of data from the Collaborative Psychiatric Epidemiology Surveys found the following association between adult ADHD and obesity (Pagoto, 2009):
| Overweight | 33.0% | 28.8% |
| Obese | 29.4% | 21.6% |
References
Cortese, Samuele et al. (2015). Association Between ADHD and Obesity: A Systematic Review and Meta-Analysis. American Journal of Psychiatry (Ahead of Print).
Elia, Josephine et al. (2008). ADHD characteristics: I. Concurrent co-morbidity patterns in children & adolescents. Child and Adolescent Psychiatry and Mental Health, 2:15.
DuPaul, George J. et al. (2013). Comorbidity of LD and ADHD: Implications of DSM-5 for Assessment and Treatment. Journal of Learning Disabilities 46(1):43–51.
Kessler et al. (April 2006). The Prevalence and Correlates of Adult ADHD in the United States: Results From the National Comorbidity Survey Replication, American Journal of Psychiatry 163(5):71.
Kraut AA et al. (2013). Comorbidities in ADHD children treated with methylphenidate: a database study. BMC Psychiatry 13:11.
Larson, Kandyce et al. (2011). Patterns of Comorbidity, Functioning, and Service Use for US Children With ADHD, 2007. Pediatrics, 127(3):462–470.
National Center for Learning Disabilities (NCLD) (2014). The State of Learning Disabilities: Facts, Trends and Indicators, New York.
Pagoto, Sherry L. et al. (March 2009). Association Between Adult Attention Deficit/Hyperactivity Disorder and Obesity in the US Population. Obesity 17(3):539–544.
Yoshimasu, Kouichi et al. (September 2011). Written-Language Disorder Among Children With and Without ADHD in a Population-Based Birth Cohort. Pediatrics 128(3):e605–e612.