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Year : 2014  |  Volume : 35  |  Issue : 2  |  Page : 71-79

Some neuropsychiatric comorbidities of attention deficit hyperactivity disorder

Department of Neurology and Psychiatry, Faculty of Medicine, Benha University Hospital, Benha University, Benha, Egypt

Correspondence Address:
Dr. Mohamed M. El-Hamady
MD, Assistant Prof. of Psychiatry, Department of Neurology and Psychiatry, Faculty of Medicine, Benha University Hospital, Benha University, Benha 13518
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-1105.134192

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Objectives The aim of the study was to find out the possible neurological and psychiatric comorbid disorders that might be associated with attention deficit hyperactivity disorder (ADHD) and to assess the intelligence quotient (IQ) in the diagnosed patients, and hence improve the accurate diagnosis of ADHD and its management. Patients and methods This study is a comparative cross-sectional study (the study group and the control group). Participants were recruited from the Neuropsychiatric and Pediatric Clinics in Benha University Hospital, in addition to some private clinics and centers. The sample size of this study was 74 (divided into two groups, the study and the control groups). Participants were chosen by nonrandom technique; all patients who fulfilled the inclusion criteria and accepted (their parents) to participate were included in the study. All case and control groups were subjected to a semistructured interview, complete neuropsychiatric clinical assessment, psychometric testing using Wechsler Intelligence Scale for Children, Conners Parent Rating Scale-revised, long version, and Revised Behavior Problem Checklist. Electroencephalography was performed for some cases and controls. Results The mean age of the ADHD children was 8.78 years old; it was more prevalent among boys. Perinatal problems were significantly prevailing among cases of ADHD. In all, 70.3% had ADHD combined type, 10.8% had ADHD predominantly hyperactive-impulsive, and 18.9% had ADHD predominantly inattentive type. The control group showed higher mean IQ of 105.4 ± 9.6 compared with the ADHD case group who showed mean IQ of 93.8 ± 10.7. There were several significant comorbidities such as delayed language development, delayed developmental milestones, oppositional defiant disorder, conduct disorder, depressive symptoms, sleep disturbance, nocturnal enuresis, and soft neurological signs. Conners scale showed that the ADHD children showed higher mean in all Conners test items than the control group. ADHD children had higher mean along all Revised Behavior Problem Checklist compared with the control group. With respect to correlations, the oppositional defiant disorder was significantly correlated to the combined type ADHD. There was statistical significant difference in the whole sample where children who did not have oppositional defiant disorder had higher IQ (101.5 ± 11.5) than those who did (95 ± 11.1). Conclusion ADHD is a disorder that carries several neuropsychiatric comorbidities. Assessment of children with ADHD should address these comorbidities, and management should focus on them to obtain best outcomes for the patients.

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