TY - JOUR
T1 - Comorbidity prevalence and treatment outcome in children and adolescents with ADHD
AU - Reale, Laura
AU - Bartoli, Beatrice
AU - Cartabia, Massimo
AU - Zanetti, Michele
AU - Costantino, Maria Antonella
AU - Canevini, Maria Paola
AU - Termine, Cristiano
AU - Bonati, Maurizio
AU - Conte, Stefano
AU - Renzetti, Valeria
AU - Salvoni, Laura
AU - Molteni, Massimo
AU - Salandi, Antonio
AU - Trabattoni, Sara
AU - Effedri, Paola
AU - Filippini, Elena
AU - Pedercini, Elisabetta
AU - Zanetti, Edda
AU - Fteita, Nadia
AU - Arisi, Daniele
AU - Mapelli, Roberta
AU - Frassica, Simona
AU - Oriani, Simonetta
AU - Trevisan, Christian
AU - Acquistapace, Susanna
AU - Martinelli, Ottaviano
AU - Villani, Davide
AU - Binaghi, Emanuela
AU - Deriu, Andrea
AU - Ricotta, Ernesta
AU - Borchia, Arianna
AU - Morosini, Paola
AU - Breviglieri, Maddalena
AU - Capovilla, Giuseppe
AU - Segala, Roberto
AU - Bissoli, Claudio
AU - Bonati, Maurizio
AU - Canevini, Maria Paola
AU - Cartabia, Massimo
AU - Costantino, Maria Antonella
AU - Cropanese, Isabella
AU - Fornaro, Emiddio
AU - Merati, Silvia
AU - Ottolini, Alberto
AU - Reale, Laura
AU - Saccani, Monica
AU - Vaccari, Roberto
AU - Balottin, Umberto
AU - Chiappedi, Matteo
AU - Rossi, Giorgio
AU - On Behalf Of Lombardy Adhd Group
PY - 2017
Y1 - 2017
N2 - Although ADHD comorbidity has been widely studied, some issues remain unsolved. This multicenter observational study aims to examine comorbid psychiatric disorders in a clinical sample of newly diagnosed, treatment naïve children and adolescents with and without ADHD and, to compare treatment efficacy based on the type of comorbidity. We performed an analysis of the medical records of patients identified from the Regional ADHD Registry database, enrolled in 18 ADHD centers in the 2011–2016 period. 1919 of 2861 subjects evaluated (67%) met the diagnostic criteria for ADHD: 650 (34%) had only ADHD, while 1269 (66%) had at least one comorbid psychiatric disorder (learning disorders, 56%; sleep disorders, 23%; oppositional defiant disorder, 20%; anxiety disorders, 12%). Patients with ADHD of combined type and with severe impairment (CGI-S ≥5) were more likely to present comorbidity. 382 of 724 (53%) followed up patients improved after 1 year of treatment. ADHD with comorbidity showed greater improvement when treated with combined interventions or methylphenidate alone. Specifically, combined treatment showed significant superiority for ADHD with learning disorders (ES 0.66) and ODD (ES 0.98), lower for ADHD with sleep or anxiety disorders. Training intervention alone showed only medium efficacy (ES 0.50) for ADHD and learning disorders. This study was the first describing comorbidity patterns of ADHD in Italy, confirming, in a multicenter clinical setting, that ADHD is more often a complex disorder. Findings highlight important diagnostic, therapeutic, and service organization aspects that should be broadly extended to ensure an appropriate and homogenous ADHD management.
AB - Although ADHD comorbidity has been widely studied, some issues remain unsolved. This multicenter observational study aims to examine comorbid psychiatric disorders in a clinical sample of newly diagnosed, treatment naïve children and adolescents with and without ADHD and, to compare treatment efficacy based on the type of comorbidity. We performed an analysis of the medical records of patients identified from the Regional ADHD Registry database, enrolled in 18 ADHD centers in the 2011–2016 period. 1919 of 2861 subjects evaluated (67%) met the diagnostic criteria for ADHD: 650 (34%) had only ADHD, while 1269 (66%) had at least one comorbid psychiatric disorder (learning disorders, 56%; sleep disorders, 23%; oppositional defiant disorder, 20%; anxiety disorders, 12%). Patients with ADHD of combined type and with severe impairment (CGI-S ≥5) were more likely to present comorbidity. 382 of 724 (53%) followed up patients improved after 1 year of treatment. ADHD with comorbidity showed greater improvement when treated with combined interventions or methylphenidate alone. Specifically, combined treatment showed significant superiority for ADHD with learning disorders (ES 0.66) and ODD (ES 0.98), lower for ADHD with sleep or anxiety disorders. Training intervention alone showed only medium efficacy (ES 0.50) for ADHD and learning disorders. This study was the first describing comorbidity patterns of ADHD in Italy, confirming, in a multicenter clinical setting, that ADHD is more often a complex disorder. Findings highlight important diagnostic, therapeutic, and service organization aspects that should be broadly extended to ensure an appropriate and homogenous ADHD management.
KW - Adolescents
KW - Attention deficit hyperactivity disorder
KW - Children
KW - Comorbidity
KW - Treatment outcome
UR - http://www.scopus.com/inward/record.url?scp=85019601334&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019601334&partnerID=8YFLogxK
U2 - 10.1007/s00787-017-1005-z
DO - 10.1007/s00787-017-1005-z
M3 - Article
AN - SCOPUS:85019601334
VL - 26
SP - 1443
EP - 1457
JO - European Child and Adolescent Psychiatry
JF - European Child and Adolescent Psychiatry
SN - 1018-8827
IS - 12
ER -