European Child & Adolescent Psychiatry

, Volume 13, Issue 5, pp 307–314 | Cite as

The clinical necessity for assessing Attention Deficit/Hyperactivity Disorder (AD/HD) symptoms in children with high-functioning Pervasive Developmental Disorder (PDD)

  • Yuko YoshidaEmail author
  • Tokio Uchiyama


Although the DSM-IV diagnostic criteria for Attention Deficit/Hyperactivity Disorder (AD/HD) exclude Pervasive Developmental Disorder (PDD), some clinicians find that the two disorders can be comorbid and, in fact, make a dual diagnosis. Nevertheless, few empirical studies have investigated the clinical necessity for this practice. In the first of our two studies, children with high-functioning PDD were selected from among 520 outpatients. Of these, children also meeting the DSM-IV criteria for AD/HD were identified through a psychologist’ts observation, the completion of the ADHD-Rating Scale by parents and/or teachers, and a child psychiatrist’s examination. We then examined the impact of PDD subtype and age on the co-occurrence rate. Study 2 analyzed comorbidity in two cases taken from Study 1. Of the 53 subjects in Study 1, 36 children also met the DSM-IV criteria for AD/HD. The co-occurrence rate for Asperger’s Disorder (AS)/Pervasive Developmental Disorder, Not Otherwise Specified (PDDNOS) (85%) was significantly higher than for Autistic Disorder (57.6 %), and AD/HD symptoms were more common in younger children. Study 2 demonstrated the existence of comorbidity of PDD and AD/HD as separate disorders. We conclude not only that AD/HD symptoms occur frequently in children with PDD, but also that in some cases a dual diagnosis is essential to the implementation of effective treatment.

Key words

AD/HD high-functioning PDD DSM-IV comorbidity 


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  1. 1.
    American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn, American Psychiatric Association, Washington, DCGoogle Scholar
  2. 2.
    Applegate B, Lahey BB, Hart EL, Biederman J, Hynd GW, Barkley RA, Ollendick T, Frick PJ, Greenhill L, McBurnett K, Newcorn JH, Kerdyk L, Garfinkel B, Waldman I, Shaffer D (1997) Validity of the age-of-onset criterion for ADHD: A report from the DSM-IV field trials. J Am Acad Child Adolesc Psychiatry 36:1211–1221CrossRefPubMedGoogle Scholar
  3. 3.
    Clark T, Feehan C, Tinline C, Vostanis P (1999) Autistic symptoms in children with attention deficit-hyperactivity disorder. Eur Child Adolesc Psychiatry 8:50–55CrossRefPubMedGoogle Scholar
  4. 4.
    Ehlers S, Gillberg C (1993) The epidemiology of Asperger Syndrome: a total population study. J Child Psychol Psychiatry 34:1327–1350PubMedGoogle Scholar
  5. 5.
    Eisenmajer R, Prior M, Leekam S, Wing L, Gould J, Welham M, Ong B (1996) Comparison of clinical symptoms in autism and Asperger’s disorder. J Am Acad Child Adolesc Psychiatry 35:1523–1531CrossRefPubMedGoogle Scholar
  6. 6.
    Gillberg IC (1987) Deficits in attention, motor control and perception: follow-up from pre-school to the early teens. Acta Universitatis Upsaliensis 133:9–51Google Scholar
  7. 7.
    Gillberg IC, Gillberg C (1989) Asperger syndrome—some epidemiological considerations: a research note. J Child Psychol Psychiatry 30:631–638PubMedGoogle Scholar
  8. 8.
    Ghaziuddin M, Weidmer-Mikhail E, Ghaziuddin N (1998) Comorbidity of Asperger syndrome: a preliminary report. J Intellect Disab Res 42:279–283Google Scholar
  9. 9.
    Jensen VK, Larrieu JA, Mack KK (1997) Differential diagnosis between attention-deficit/hyperactivity disorder and pervasive developmental disorder not otherwise specified. Clin Pediatr (Phila) 36:555–561Google Scholar
  10. 10.
    Lahey BB, Applegate B, McBurnett K, Biederman J, Greenhill L, Hynd GW, Barkley RA, Newcorn JH, Jensen P, Richters J, Garfinkel B, Kerdyk L, Frick PJ, Ollendick T, Perez D, Hart EL, Waldman I, Shaffer D (1994) DSMIV field trials for attention deficit hyperactivity disorder in children and adolescents. Am J Psychiatry 151:1673–1685PubMedGoogle Scholar
  11. 11.
    Lord C (2000) Autism spectrum disorder and ADHD. In: Accard PJ, Blondis TA, Whitman BY, Stein MA (eds) Attention deficits and hyperactivity in children and adults. Marcel Dekker, New York, pp 401–417Google Scholar
  12. 12.
    Klin A, Volkmar FR (1997) Asperger’s syndrome. In: Cohen DJ, Volkmar FR (eds) Handbook of autism and pervasive developmental disorders. 2nd edn. Wiley, New York, p 118Google Scholar
  13. 13.
    Ozonoff S, Dawson G, McPartland J (2002) Understanding Asperger syndrome and high-functioning autism: the diagnostic process. In: A parent’s guide to Asperger syndrome and highfunctioning autism. Guilford Press, New York, pp 22–55Google Scholar
  14. 14.
    Perry R (1998) Misdiagnosed ADD/ADHD: rediagnosed PDD. J Am Acad Child Adolesc Psychiatry 37:113–114CrossRefPubMedGoogle Scholar
  15. 15.
    Schatz AM, Weimer AK, Trauner AD (2002) Brief report: attention differences in Asperger syndrome. J Autism Devel Disord 32:333–336CrossRefGoogle Scholar
  16. 16.
    Wing L (1981) Asperger’s syndrome: a clinical account. Psychol Med 11:115–129Google Scholar
  17. 17.
    Wing L (1996) The autistic spectrum: a guide for parents and professionals. Constable, London, p 66Google Scholar
  18. 18.
    Wing L (1997) The autistic spectrum. Lancet 350:1761–1766CrossRefPubMedGoogle Scholar
  19. 19.
    World Health Organization (1993) The ICD-10 Classification of Mental and Behavioral Disorders: Diagnostic Criteria for Research. World Health Organization, GenevaGoogle Scholar
  20. 20.
    Yamazaki K (2003) ADHD—rating scale IV, Japanese version. In: Kanbayashi Y, Saito K, Kita M (eds) Guideline to Attention Deficit/Hyperactivity Disorder. Jihou Press, Tokyo, pp 46–54 (In Japanese) [Preliminary use of the Japanese version was permitted in this study.The items in the Japanese version are the same as the original version: DuPaul GJ, Power TJ, Anastopoulos AD, Reid R (1998) ADHD Rating Scale: checklists, norms, and clinical interpretation. Guilford Press, New York]Google Scholar

Copyright information

© Steinkopff Verlag 2004

Authors and Affiliations

  1. 1.Yokohama Psycho-Developmental ClinicTsuzuki-ku Yokohama 224-0032Japan
  2. 2.Dept. of Human WelfareOtsuma Women’s UniversityTama-city Tokyo 206-8540Japan

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