European Journal of Pediatrics

, Volume 174, Issue 9, pp 1209–1215 | Cite as

Chronic conditions and coexisting ADHD—a complicated combination in adolescents

  • Charlotte Nylander
  • Elisabeth Fernell
  • Ylva Tindberg
Original Article


Adolescents with chronic conditions (CCs) take more health risks than peers. However, coexisting ADHD has not sufficiently been considered. The aim of the present study was to investigate the impact of different CCs on protective factors and health-risk behaviors, taking coexisting ADHD into account. A school-based study among 6895 15- and 17-year-old students was performed in the county of Sörmland, Sweden in 2011 (response rate 80 %). The questionnaire explored background factors, CCs, protective factors, and health-risk behaviors. CCs were reported by 11 %, while 55 % were healthy. Students with CCs more often reported coexisting ADHD than healthy students. In adolescents with neurological conditions, the odds ratio for having ADHD was 7.34 (95 % CI 3.00–17.99) as compared to healthy peers. Few protective factors (<4) and clustered health-risk behaviors (≥4) were more common among students with CCs, especially if ADHD or a combination including ADHD was reported.

Conclusion: CCs and coexisting ADHD are associated with few protective factors and clustered-health risk behaviors. Adolescents with ADHD—in addition to a chronic condition—should be specially acknowledged by health care professionals in order to prevent health risk behaviors. ADHD should be considered when studying these outcomes in adolescents.

What is Known:

• Youth with chronic conditions (CCs)—especially ADHD—are reported to take more health risks than peers.

• In earlier studies of youth with CCs, the presence of coexisting ADHD has not been taken into account.

What is New:

• In this study, we showed that ADHD was more prevalent among adolescents with different types of CCs.

• CCs and coexisting ADHD were associated with few protective factors and clustered health-risk behaviors.


Adolescent medicine Chronic disease ADHD Health behavior Risk-taking Protective factors 



Attention deficit hyperactivity disorder


Chronic conditions



We thank Eva-Maria Annerbäck, Fredrik Granström, and Ulf Larsson at the Centre for Clinical Research Sörmland, Sweden for valuable support. We also thank Carina Seidel for fruitful discussions and Steven Lucas for help with linguistic comments. Finally, we thank all students and school staff who made this study possible.

Conflicts of Interest

This study was funded by the Centre for Clinical Research Sörmland, Uppsala University. There is no conflict of interest.

Author’s contributions

CN perfomed the statistical analyses and wrote the manuscript. EF and YT supervised the analyses and the manuscript writing.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Charlotte Nylander
    • 1
    • 2
    • 3
  • Elisabeth Fernell
    • 4
  • Ylva Tindberg
    • 1
    • 2
  1. 1.Department of Women’s and Children’s HealthUppsala UniversityUppsalaSweden
  2. 2.Centre for Clinical Research SörmlandUppsala UniversityUppsalaSweden
  3. 3.Department of PediatricsMälarsjukhuset HospitalEskilstunaSweden
  4. 4.The Gillberg Neuropsychiatry Centre, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden

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