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The Comorbidity of ADHD in the General Population of Swedish School‐age Children
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2001
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Adhd GroupsEducationMental HealthSwedish School‐age ChildrenChild Mental HealthPsychologySocial SciencesGeneral PopulationAdhdDevelopmental Coordination DisorderAutismDevelopmental DisorderBehavioural ProblemAdhd CasesChild PsychologyPopulation ChildrenPsychiatryChild DevelopmentPediatricsSpecial EducationPure AdhdChild PsychiatryPsychopathology
The study investigated comorbid diagnoses and related problems in a population sample of Swedish 7‑year‑olds with and without DSM‑III‑R ADHD. Half of a mainstream Swedish school cohort of 7‑year‑olds were clinically assessed, with parent and teacher reports, and the children were followed up 2–4 years later. Seventy‑seven percent of children with full ADHD had at least one comorbid diagnosis (most often oppositional defiant disorder and developmental coordination disorder), 71 % of subthreshold ADHD children had comorbidities, only 17 % of non‑ADHD children did, and the ADHD groups showed high rates of school adjustment, learning, and behavior problems, indicating that pure ADHD is rare and studies excluding comorbidity are not representative.
This study examined patterns of comorbid/associated diagnoses and associated problems in a population sample of children with and without DSM-III-R attention-deficit hyperactivity disorder (ADHD). Half (N = 409) of a mainstream school population of Swedish 7-year-olds were clinically examined, and parents and teachers were interviewed and completed questionnaires. The children were followed up 2-4 years later. Eighty-seven per cent of children meeting full criteria for ADHD (N = 15) had one or more and 67% at least two--comorbid diagnoses. The most common comorbidities were oppositional defiant disorder and developmental coordination disorder. Children with subthreshold ADHD (N = 42) also had very high rates of comorbid diagnoses (71% and 36%), whereas those without ADHD (N = 352) had much lower rates (17% and 3%). The rate of associated school adjustment, learning, and behaviour problems at follow-up was very high in the ADHD groups. We concluded that pure ADHD is rare even in a general population sample. Thus, studies reporting on ADHD cases without comorbidity probably refer to highly atypical samples. By and large, such studies cannot inform rational clinical decisions.