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Clinical Subtypes in Children with Attention-Deficit Hyperactivity Disorder According to Their Child Behavior Checklist Profile

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Abstract

This study sought to identify subgroups of attention-deficit hyperactivity disorder (ADHD) defined by specific patterns of emotional and behavioral symptoms according to the parent-rated Child Behavior Checklist (CBCL). Our clinical sample comprised 314 children (aged 4 to 15 years) diagnosed with ADHD according to the DSM-5. In addition, comorbid psychiatric disorders, general functioning, and medication status were assessed. Cluster analysis was performed on the CBCL syndrome subscales and yielded a solution with four distinct subgroups. The “High internalizing/externalizing” group displayed an overlap between internalizing and externalizing problems in the CBCL profile. In addition, the “High internalizing/externalizing” group revealed a high rate of comorbid autism spectrum disorder and elevated autistic traits. The “Inattention and internalizing” group revealed a high rate of the predominantly inattentive presentation according to ADHD specifier from the DSM-5. The “Aggression and externalizing” group revealed a high rate of comorbid oppositional defiant disorder and conduct disorder. The “Less psychopathology” group scored low on all syndrome scales. Children with ADHD were subdivided into four distinct subgroups characterized by psychopathological patterns, with and without internalizing and externalizing problems. The overlap between internalizing and externalizing problems may be mediated with emotional dysregulation and associated neurobiological bases.

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Acknowledgements

We thank the participants in this study. We would also like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Child Psychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Daisuke Katsuki, Hiroshi Yamashita & Kenichi Yamane

  2. Japan Depression Center, Tokyo, Japan

    Shigenobu Kanba

  3. Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashiku, Fukuoka City, Fukuoka, 8128582, Japan

    Daisuke Katsuki, Shigenobu Kanba & Keiko Yoshida

  4. Iris Psychiatric Clinic, Fukuoka, Japan

    Keiko Yoshida

Authors
  1. Daisuke Katsuki
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  2. Hiroshi Yamashita
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  4. Shigenobu Kanba
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  5. Keiko Yoshida
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Contributions

DK, HY, and KY conceived and designed the study. DK acquired the data and performed the statistical analyses. DK and HY wrote the manuscript. KY and SK contributed to critical revision of the manuscript and approved the final version.

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Correspondence to Daisuke Katsuki.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Katsuki, D., Yamashita, H., Yamane, K. et al. Clinical Subtypes in Children with Attention-Deficit Hyperactivity Disorder According to Their Child Behavior Checklist Profile. Child Psychiatry Hum Dev 51, 969–977 (2020). https://doi.org/10.1007/s10578-020-00977-8

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