Comorbiditari ADHD

I.

ADHD in adults-what science says:

Like children with ADHD, adults with the disorder have been found in
prior studies to have a greater risk for comorbid oppositional defiant disorder
(ODD) and conduct disorder (CD) than do either clinical control groups with
out
a diagnosis of ADHD or normal, nonreferred adults. Approximately 24 to
35% of clinic-referred adults diagnosed with ADHD have ODD and 17 to 25%
have CD, either currently or over the course of their earlier development
(Barkley, Murphy, & Kwasnik, 1996; Biederman et al., 1993; Murphy &
Barkley, 1996; Murphy et al., 2002; Spencer, 2004). These figures for clinicreferred
adults are below those reported in studies of ADHD children, particu
larly
studies of hyperactive children followed to adulthood, where levels of ODD
and CD may be double or triple these rates reported for adults diagnosed with
ADHD (see Barkley, 2006, for a review; Barkley et al., 1990; Fischer et al., 2002;
Weiss & Hechtman, 1993). Among parents of children having ADHD who also
meet criteria for ADHD, disruptive behavior disorders also occur significantly

Antisocial personality disorder is often an associ

ated
adult outcome in a large minority of those children or adolescents who have
both ADHD and CD; thus it is not surprising to find that 7 to 44% of clinicreferred
adults diagnosed with ADHD also qualify for a diagnosis of this person
ality
disorder (Biederman et al., 1993; Shekim et al., 1990; Torgersen, Gjervab,
& Rasmussen, 2006). Even among those who do not qualify for this diagnosis,
many receive higher than normal ratings on those personality traits associated
with this personality disorder (Tzelepis, Schubiner, & Warbase, 1995).
with this personality disorder (Tzelepis, Schubiner, & Warbase, 1995).
Substance dependence and abuse are known to occur to a more frequent
degree among hyperactive children or children with ADHD who develop CD
by adolescence or antisocial personality disorder by adulthood (Barkley, 2006;
Tercyak, Peshkin, Walker, & Stein, 2002). A recent study of a large general pop
ulation
sample likewise found an association between ADHD in adults and anti
social
personality disorder (Kessler et al., 2006). Adults clinically diagnosed with
ADHD seem to be no exception to this rule, linking ADHD with antisocial
activities as well as with drug use disorders. Studies have found lifetime rates of
alcohol dependence or abuse disorders ranging between 21% and 53% of adults