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Psychiatric comorbidity and functional impairment in a clinically referred sample of adults with attention-deficit/hyperactivity disorder (ADHD)

European Archives of Psychiatry and Clinical Neuroscience volume 257, pages 371–377 (2007)Cite this article

Abstract

Objective

This exploratory study aims to compare lifetime psychiatric axis-I-comorbidity and psychosocial functioning in a clinically referred sample of adult patients with attention-deficit/hyperactivity disorder (ADHD) with a population-based healthy control group and to examine whether patients with ADHD and lifetime comorbid diagnoses differ from patients with pure ADHD in their functional impairment.

Method

Seventy adult patients with ADHD according to DSM-IV criteria and a gender- as well as age-matched population based control group underwent diagnostic evaluations with clinical interviews for ADHD, DSM-IV disorders and demographic information.

Results

The prevalence of psychiatric lifetime comorbidity was 77.1% in patients with ADHD and thus exceeded the rate in the control group, which was 45.7%. Significantly more patients suffered from depressive episodes, substance related disorders and eating disorders. Compared to the control group adults with ADHD were significantly impaired in a variety of psychosocial functions (education, occupational training). Patients with ADHD and lifetime diagnosis of comorbid psychiatric disorders differed from patients with pure ADHD in their psychosocial functioning only in the percentage of unemployed individuals, which was higher in patients with psychiatric comorbidity.

Conclusion

Adults with ADHD suffer significantly more often from other psychiatric disorders than individuals of the population-based control group and are impaired in several areas of psychosocial functioning. Poor psychosocial outcome is primarily related to ADHD and not to additional psychiatric disorders. Due to the limited number of assessed patients these results need to be confirmed by studies with larger sample size.

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Acknowledgements

We would like to thank Uwe Ruhl, Georg-August-Universität, Göttingen, for making us the use of the German version of the Brown attention deficit disorders scales available.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, J 5, 68159, Mannheim, Germany

    Esther Sobanski, Daniel Brüggemann, Barbara Alm & Sebastian Kern

  2. Division of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, J 5, 68159, Mannheim, Germany

    Monika Deschner & Marcella Rietschel

  3. Psychiatrisches Zentrum Stadtmitte, E 2-15, 68159, Mannheim, Germany

    Thomas Schubert

  4. Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstr. 5, 79104, Freiburg, Germany

    Alexandra Philipsen

Authors
  1. Esther Sobanski
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  2. Daniel Brüggemann
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Correspondence to Esther Sobanski.

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Sobanski, E., Brüggemann, D., Alm, B. et al. Psychiatric comorbidity and functional impairment in a clinically referred sample of adults with attention-deficit/hyperactivity disorder (ADHD). Eur Arch Psychiatry Clin Neurosc 257, 371–377 (2007). https://doi.org/10.1007/s00406-007-0712-8

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Keywords

  • adult attention-deficit/hyperactivity disorder
  • ADHD
  • psychiatric comorbidity
  • psychosocial functioning