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Am J Psychiatry 1991; 148:564-577
Copyright © 1991 by American Psychiatric Association
Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders
J Biederman, J Newcorn and S Sprich
Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114.
OBJECTIVE: Attention deficit hyperactivity disorder is a heterogeneous
disorder of unknown etiology. Little is known about the comorbidity of this
disorder with disorders other than conduct. Therefore, the authors made a
systematic search of the psychiatric and psychological literature for
empirical studies dealing with the comorbidity of attention deficit
hyperactivity disorder with other disorders. DATA COLLECTION: The search
terms included hyperactivity, hyperkinesis, attention deficit disorder, and
attention deficit hyperactivity disorder, cross-referenced with antisocial
disorder (aggression, conduct disorder, antisocial disorder), depression
(depression, mania, depressive disorder, bipolar), anxiety (anxiety
disorder, anxiety), learning problems (learning, learning disability,
academic achievement), substance abuse (alcoholism, drug abuse), mental
retardation, and Tourette's disorder. FINDINGS: The literature supports
considerable comorbidity of attention deficit hyperactivity disorder with
conduct disorder, oppositional defiant disorder, mood disorders, anxiety
disorders, learning disabilities, and other disorders, such as mental
retardation, Tourette's syndrome, and borderline personality disorder.
CONCLUSIONS: Subgroups of children with attention deficit hyperactivity
disorder might be delineated on the basis of the disorder's comorbidity
with other disorders. These subgroups may have differing risk factors,
clinical courses, and pharmacological responses. Thus, their proper
identification may lead to refinements in preventive and treatment
strategies. Investigation of these issues should help to clarify the
etiology, course, and outcome of attention deficit hyperactivity disorder.
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