Skip to main content

Advertisement

SpringerLink
Log in

Comorbidities of Attention Deficit Hyperactivity Disorder: Pregnancy Risk Factors and Parent Mental Health

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

Our study examined the risk of maternal smoking and alcohol consumption in pregnancy associated with child comorbidity in a community sample of children diagnosed with attention deficit hyperactivity disorder (ADHD). We used a cross sectional community retrospective questionnaire of 321 children diagnosed with ADHD. Our results suggest that maternal smoking increased the risk of oppositional defiant behavior (ODB) in children with ADHD twofold (OR 2.27; CI 1.29–4.11). Maternal alcohol consumption increased the risk although not significantly for ADHD child comorbid ODB, anxiety disorder and depression. Parent mental health significantly impacted on child comorbidity. Our study suggests that smoking in pregnancy is associated with comorbid ODB, independent of parent mental health, family history of ADHD and socioeconomic factors. Parent mental health is independently associated with comorbid ODB, anxiety disorder and depression.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental health disorders (4th ed.). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Anastopoulos, A. D., Guevremont, D. C., Shelton, T. L., & DuPaul, G. J. (1992). Parenting stress among families of children with attention deficit hyperactivity disorder. Journal of Abnormal Child Psychology, 20, 503–520.

    Article  CAS  PubMed  Google Scholar 

  • Arnold, A. S., Liu, M. Q., Schwartz, M. H., Ounpuu, S., & Delp, S. L. (2006). The role of estimating muscle-tendon lengths and velocities of the hamstrings in the evaluation and treatment of crouch gait. Gait Posture, 23, 273–281.

    Article  PubMed  Google Scholar 

  • Banerjee, T. D., Middleton, F., & Faraone, S. V. (2007). Environmental risk factors for attention-deficit hyperactivity disorder. Acta Paediatrica, 96, 1269–1274.

    Article  PubMed  Google Scholar 

  • Biederman, J., & Faraone, S. V. (2005). Attention-deficit hyperactivity disorder. Lancet, 366, 237–248.

    Article  PubMed  Google Scholar 

  • Biederman, J., Monuteaux, M. C., Mick, E., Spencer, T., Wilens, T. E., Silva, J. M., et al. (2006). Young adult outcome of attention deficit hyperactivity disorder: A controlled 10-year follow-up study. Psychological Medicine, 36, 167–179.

    Article  PubMed  Google Scholar 

  • Booster, G. D., Dupaul, G. J., Eiraldi, R., & Power, T. J. (2012). Functional impairments in children with ADHD: Unique effects of age and comorbid status. Journal of Attention Disorders, 16, 179–189.

    Article  PubMed  Google Scholar 

  • De Los Reyes, A., & Kazdin, A. E. (2005). Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations for further study. Psychological Bulletin, 131, 483–509.

    Article  PubMed  Google Scholar 

  • Famy, C., Streissguth, A. P., & Unis, A. S. (1998). Mental illness in adults with fetal alcohol syndrome or fetal alcohol effects. The American Journal of Psychiatry, 155, 552–554.

    Article  CAS  PubMed  Google Scholar 

  • Faraone, S. V., Biederman, J., & Milberger, S. (1995). How reliable are maternal reports of their children’s psychopathology? One-year recall of psychiatric diagnoses of ADHD children. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1001–1008.

    Article  CAS  PubMed  Google Scholar 

  • Gillberg, C., Gillberg, I. C., Rasmussen, P., Kadesjo, B., Soderstrom, H., Rastam, M., et al. (2004). Co-existing disorders in ADHD—Implications for diagnosis and intervention. European Child and Adolescent Psychiatry, 13(Suppl 1), I80–I92.

    PubMed  Google Scholar 

  • Graetz, B. W., Sawyer, M. G., Hazell, P. L., Arney, F., & Baghurst, P. (2001). Validity of DSM-IVADHD subtypes in a nationally representative sample of Australian children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1410–1417.

    Article  CAS  PubMed  Google Scholar 

  • Gustafsson, P., & Kallen, K. (2011). Perinatal, maternal, and fetal characteristics of children diagnosed with attention-deficit-hyperactivity disorder: Results from a population-based study utilizing the Swedish Medical Birth Register. Developmental Medicine and Child Neurology, 53, 263–268.

    Article  PubMed  Google Scholar 

  • Halmoy, A., Klungsoyr, K., Skjaerven, R., & Haavik, J. (2012). Pre- and perinatal risk factors in adults with attention-deficit/hyperactivity disorder. Biological Psychiatry, 71, 474–481.

    Article  PubMed  Google Scholar 

  • Harris, K., Boots, M., Talbot, J., & Vance, A. (2006). Comparison of psychosocial correlates in primary school age children with attention deficit/hyperactivity disorder-combined type, with and without dysthymic disorder. Child Psychiatry and Human Development, 36, 419–426.

    Article  PubMed  Google Scholar 

  • Huizink, A. C., & Mulder, E. J. (2006). Maternal smoking, drinking or cannabis use during pregnancy and neurobehavioral and cognitive functioning in human offspring. Neuroscience and Biobehavioral Reviews, 30, 24–41.

    Article  CAS  PubMed  Google Scholar 

  • Huss, M., Holling, H., Kurth, B. M., & Schlack, R. (2008). How often are German children and adolescents diagnosed with ADHD? Prevalence based on the judgment of health care professionals: Results of the German health and examination survey (KiGGS). European Child and Adolescent Psychiatry, 17(Suppl 1), 52–58.

    Article  PubMed  Google Scholar 

  • Ikonomidou, C., Bittigau, P., Ishimaru, M. J., Wozniak, D. F., Koch, C., Genz, K., et al. (2000). Ethanol-induced apoptotic neurodegeneration and fetal alcohol syndrome. Science, 287, 1056–1060.

    Article  CAS  PubMed  Google Scholar 

  • Indredavik, M. S., Brubakk, A. M., Romundstad, P., & Vik, T. (2007). Prenatal smoking exposure and psychiatric symptoms in adolescence. Acta Paediatrica, 96, 377–382.

    Article  PubMed Central  PubMed  Google Scholar 

  • Jarrett, M. A., & Ollendick, T. H. (2008). A conceptual review of the comorbidity of attention-deficit/hyperactivity disorder and anxiety: Implications for future research and practice. Clinical Psychology Review, 28, 1266–1280.

    Article  PubMed  Google Scholar 

  • Jensen, P. S., Martin, D., & Cantwell, D. P. (1997). Comorbidity in ADHD: Implications for research, practice, and DSM-V. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1065–1079.

    Article  CAS  PubMed  Google Scholar 

  • Kim, H. H., Viner-Brown, S. I., & Garcia, J. (2007). Children’s mental health and family functioning in Rhode Island. Pediatrics, 119(Suppl 1), S22–S28.

    Article  PubMed  Google Scholar 

  • Kodituwakku, P. W. (2007). Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: A review. Neuroscience and Biobehavioral Reviews, 31, 192–201.

    Article  CAS  PubMed  Google Scholar 

  • Langley, K., Heron, J., Smith, G. D., & Thapar, A. (2012). Maternal and paternal smoking during pregnancy and risk of ADHD symptoms in offspring: Testing for intrauterine effects. American Journal of Epidemiology, 176, 261–268.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lichtenstein, P., Carlstrom, E., Rastam, M., Gillberg, C., & Anckarsater, H. (2010). The genetics of autism spectrum disorders and related neuropsychiatric disorders in childhood. The American Journal of Psychiatry, 167, 1357–1363.

    Article  PubMed  Google Scholar 

  • Lindblad, F., & Hjern, A. (2010). ADHD after fetal exposure to maternal smoking. Nicotine & Tobacco Research, 12, 408–415.

    Article  CAS  Google Scholar 

  • Lindstrom, K., Lindblad, F., & Hjern, A. (2011). Preterm birth and attention-deficit/hyperactivity disorder in schoolchildren. Pediatrics, 127, 858–865.

    Article  PubMed  Google Scholar 

  • Linnet, K. M., Dalsgaard, S., Obel, C., Wisborg, K., Henriksen, T. B., Rodriguez, A., et al. (2003). Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: Review of the current evidence. American Journal of Psychiatry, 160, 1028–1040.

    Article  PubMed  Google Scholar 

  • Mick, E., Biederman, J., Faraone, S. V., Sayer, J., & Kleinman, S. (2002). Case–control study of attention-deficit hyperactivity disorder and maternal smoking, alcohol use, and drug use during pregnancy. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 378–385.

    Article  PubMed  Google Scholar 

  • Motlagh, M. G., Sukhodolsky, D. G., Landeros-Weisenberger, A., Katsovich, L., Thompson, N., Scahill, L., et al. (2011). Adverse effects of heavy prenatal maternal smoking on attentional control in children with ADHD. Journal of Attention Disorders, 15, 593–603.

    Article  PubMed Central  PubMed  Google Scholar 

  • National Health Survey: Summary of results. CDATA01. (2006). Australian Bureau of Statistics. CDATA01. Canberra, ACT: Australia.

  • Neuman, R. J., Lobos, E., Reich, W., Henderson, C. A., Sun, L. W., & Todd, R. D. (2007). Prenatal smoking exposure and dopaminergic genotypes interact to cause a severe ADHD subtype. Biological Psychiatry, 61, 1320–1328.

    Article  CAS  PubMed  Google Scholar 

  • Nigg, J., Nikolas, M., & Burt, S. A. (2010). Measured gene-by-environment interaction in relation to attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 863–873.

    Article  PubMed Central  PubMed  Google Scholar 

  • Obel, C., Olsen, J., Henriksen, T. B., Rodriguez, A., Jarvelin, M. R., Moilanen, I., et al. (2011). Is maternal smoking during pregnancy a risk factor for hyperkinetic disorder? Findings from a sibling design. International Journal of Epidemiology, 40, 338–345.

    Article  PubMed  Google Scholar 

  • O’Connor, M. J., Shah, B., Whaley, S., Cronin, P., Gunderson, B., & Graham, J. (2002). Psychiatric illness in a clinical sample of children with prenatal alcohol exposure. American Journal of Drug and Alcohol Abuse, 28, 743–754.

    Article  PubMed  Google Scholar 

  • O’Malley, K. D., & Nanson, J. (2002). Clinical implications of a link between fetal alcohol spectrum disorder and attention-deficit hyperactivity disorder. Canadian journal of psychiatry Revue canadienne de psychiatrie, 47, 349–354.

    PubMed  Google Scholar 

  • Ostrander, R., Crystal, D. S., & August, G. (2006). Attention deficit-hyperactivity disorder, depression, and self- and other-assessments of social competence: A developmental study. Journal of Abnormal Child Psychology, 34, 773–787.

    Article  PubMed  Google Scholar 

  • Owens, E. B., & Hinshaw, S. P. (2013). Perinatal problems and psychiatric comorbidity among children with ADHD. Journal of Clinical Child and Adolescent, 42, 762–768.

  • Peadon, E., & Elliott, E. J. (2010). Distinguishing between attention-deficit hyperactivity and fetal alcohol spectrum disorders in children: Clinical guidelines. Neuropsychiatric Disease and Treatment, 6, 509–515.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Pelham, W. E, Jr, Fabiano, G. A., & Massetti, G. M. (2005). Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 449–476.

    Article  PubMed  Google Scholar 

  • Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007). The worldwide prevalence of ADHD: A systematic review and metaregression analysis. American Journal of Psychiatry, 164, 942–948.

    Article  PubMed  Google Scholar 

  • Rhodes, S. M., Park, J., Seth, S., & Coghill, D. R. (2012). A comprehensive investigation of memory impairment in attention deficit hyperactivity disorder and oppositional defiant disorder. Journal of Child Psychology and Psychiatry, 53, 128–137.

    Article  PubMed  Google Scholar 

  • Rodriguez, A., Olsen, J., Kotimaa, A. J., Kaakinen, M., Moilanen, I., Henriksen, T. B., et al. (2009). Is prenatal alcohol exposure related to inattention and hyperactivity symptoms in children? Disentangling the effects of social adversity. Journal of Child Psychology and Psychiatry, 50, 1073–1083.

    Article  CAS  PubMed  Google Scholar 

  • Salekin, R. T., & Lynam, D. (2010). Child and adolescent psychopathy: An introduction. In R. T. Salekin & D. Lynam (Eds.), Handbook of child and adolescent psychopathy (pp. 1–12). New York: Guilford Press.

    Google Scholar 

  • Silva, D., Colvin, L., Hagemann, E., & Bower, C. (2013). Environmental risk factors by gender associated with attention-deficit/hyperactivity disorder. Pediatrics, 133, e14–e22.

  • Slotkin, T. A., Pinkerton, K. E., Tate, C. A., & Seidler, F. J. (2006). Alterations of serotonin synaptic proteins in brain regions of neonatal Rhesus monkeys exposed to perinatal environmental tobacco smoke. Brain Research, 1111, 30–35.

    Article  CAS  PubMed  Google Scholar 

  • Spencer, T. J. (2006). ADHD and comorbidity in childhood. Journal of Clinical Psychiatry, 67(Suppl 8), 27–31.

    PubMed  Google Scholar 

  • Tannock, R. (2003). Neuropsychology of attention disorders. In S. J. Segalowitz & I. Rapin (Eds.), Handbook of neuropsychology, child neuropsychology, Part II (2nd ed., pp. 753–784). New York, NY: Elsevier.

    Google Scholar 

  • Thapar, A., Cooper, M., Jefferies, R., & Stergiakouli, E. (2012). What causes attention deficit hyperactivity disorder? Archives of Disease in Childhood, 97, 260–265.

  • Thapar, A., & Rutter, M. (2009). Do prenatal risk factors cause psychiatric disorder? Be wary of causal claims. British Journal of Psychiatry, 195, 100–101.

    Article  PubMed  Google Scholar 

  • Tomeo, C. A., Rich-Edwards, J. W., Michels, K. B., Berkey, C. S., Hunter, D. J., Frazier, A. L., et al. (1999). Reproducibility and validity of maternal recall of pregnancy-related events. Epidemiology, 10, 774–777.

    Article  CAS  PubMed  Google Scholar 

  • Williams, J. H., & Ross, L. (2007). Consequences of prenatal toxin exposure for mental health in children and adolescents: A systematic review. European Child and Adolescent Psychiatry, 16, 243–253.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank the pediatricians who assisted in identifying children on medication to participate in this study and the parents who completed the questionnaire. We also thank Natasha Bear who assisted with the statistical analysis.

Author information

Authors and Affiliations

  1. Telethon Kids Institute, University of Western Australia, Perth, Australia

    Desiree Silva & Carol Bower

  2. School of Paediatrics and Child Health, University of Western Australia, Perth, Australia

    Desiree Silva

  3. Joondalup Health Campus, Joondalup, Australia

    Desiree Silva

  4. Graduate School of Education, University of Western Australia, Perth, Australia

    Stephen Houghton

  5. Fremantle Speech Pathology Services, Perth, Australia

    Erika Hagemann

Authors
  1. Desiree Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephen Houghton
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erika Hagemann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carol Bower
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Desiree Silva.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Silva, D., Houghton, S., Hagemann, E. et al. Comorbidities of Attention Deficit Hyperactivity Disorder: Pregnancy Risk Factors and Parent Mental Health. Community Ment Health J 51, 738–745 (2015). https://doi.org/10.1007/s10597-014-9773-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-014-9773-0

Keywords

Search

Navigation