Personality disorders and Axis I comorbidity in adolescent outpatients with ADHD

Abstract

BackgroundAttention deficit hyperactivity disorder (ADHD) is a lifelong condition which carries great cost to society and has an extensive comorbidity. It has been assumed that ADHD is 2 to 5 times more frequent in boys than in girls. Several studies have suggested developmental trajectories that link ADHD and certain personality disorders. The present study investigated the prevalence of ADHD, common Axis I disorders, and their gender differences in a sample of adolescent outpatients. We also wanted to investigate the relationship between ADHD and personality disorders (PDs), as well as how this relationship was influenced by adjustment for Axis I disorders, age and gender.MethodsWe used a sample consisting of 153 adolescents, aged 14 to 17 years, who were referred to a non-specialized mental health outpatient clinic with a defined catchment area. ADHD, conduct disorder (CD) and other Axis I conditions were assessed using the Mini International Neuropsychiatric Interview (MINI). PDs were assessed using the Structured Interview for DSM-IV Personality (SIDP-IV).Results13.7 % of the adolescents met diagnostic criteria for ADHD, with no significant gender difference. 21.6 % had at least one PD, 17.6 % had CD, and 4.6 % had both ADHD and a PD. There was a significantly elevated number of PD symptoms in adolescents with an ADHD diagnosis (p = 0.001), and this relationship was not significantly weakened when adjusted for age, gender and other Axis I disorders (p = 0.026). Antisocial (χ2 = 21.18, p = 0.002) and borderline (χ2 = 6.15, p = 0.042) PDs were significantly more frequent in girls than in boys with ADHD.ConclusionsWe found no significant gender difference in the prevalence of ADHD in a sample of adolescents referred to a general mental health outpatient clinic. Adolescent girls with ADHD had more PDs than boys, with antisocial and borderline PDs significantly different. The present study suggests that ADHD in girls in a general outpatient population may be more prevalent than previously assumed. It especially highlights the importance of assessing antisocial and borderline personality pathology in adolescent girls presenting with ADHD symptoms.

Outpatient rehabilitation resources and medical expenditure in children with attention-deficit hyperactivity disorder in Taiwan

“…The male: female ratio was 3:1, similar to that in other studies [ 24 ]. Irrespective of the total annual cost, average cost, and average number of visits, boys used the rehabilitation resources more than girls ( p < 0.05).…”

“…ADHD has the potential to be a lifelong problem, particularly if untreated, and the burden of social costs and excessive care expenditure is significant [ 24 ]. However, in many countries, ADHD has not been diagnosed or has remained untreated, resulting in an increase in ineffective treatment and the costs incurred by this disease [ 25 ].…”

Impulsive Personality Traits Mediate the Relationship Between Adult Attention‐Deficit/Hyperactivity Symptoms and Alcohol Dependence Severity

“…Second, the generalizability of these results is limited to individuals seeking treatment for AUD. We also did not assess conduct disorder (CD), antisocial personality disorder (ASPD), or nicotine dependence symptoms that are often comorbid with ADHD (Korsgaard, Torgersen, Wentzel-Larsen, & Ulberg, 2016). These results may be reduced if CD, ASPD, or nicotine dependence symptoms are tested within the same model.…”

Borderline personality disorder and attention deficit/hyperactivity disorder in adolescence: overlap and differences in a clinical setting

“…However, very most studies conducted in adolescents on this topic reported lower rates of cooccurrence of ADHD and BPD, compared to our findings. Korsgaard et al investigated personality disorders in adolescents and found that only 4 out of 21 ADHD patients (19%) also received a BPD diagnosis [34]. Similarly, Speranza et al reported that only 11% of subjects with BPD received an ADHD diagnosis as well in their clinical sample [23] compared to 33% in our sample.…”