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Am J Psychiatry 1993; 150:1203-1209
Copyright © 1993 by American Psychiatric Association
Anxiety and depressive disorders in attention deficit disorder with hyperactivity: new findings
PS Jensen, RE Shervette 3d, SN Xenakis and J Richters
Department of Psychiatry and Neurology, Eisenhower Army Medical Center, Fort Gordon, Ga.
OBJECTIVE: The authors examined the discriminant validity of the diagnosis
of attention deficit disorder with hyperactivity. METHOD: They used
standardized rating scales of life stresses and child and family
functioning to assess psychosocial and family risk factors in 47 children
who had the diagnosis of attention deficit disorder with hyperactivity, a
matched group of 47 children in the community, and a matched group of 47
children seen in a psychiatric clinic. RESULTS: Children who had the
diagnosis of attention deficit disorder and children in the psychiatric
clinic reported significantly more depression and anxiety than did the
children in the community; furthermore, children diagnosed as having
attention deficit disorder with hyperactivity had more externalizing
symptoms than did children in the psychiatric clinic. Children diagnosed as
having attention deficit disorder with hyperactivity plus a comorbid
anxiety or depressive disorder had higher levels of coexisting life
stresses and parental symptoms than did children who had the single
diagnosis of attention deficit disorder with hyperactivity. CONCLUSIONS:
These results underscore the need for future studies to carefully assess
children diagnosed as having attention deficit disorder with hyperactivity
for concurrent psychiatric disorders as well as family and psychosocial
stressors that may contribute to childhood symptoms. Such information is
essential because different subtypes of attention deficit disorder with
comorbid disorders may arise from different etiologic pathways, may require
varying treatment options, and may foreshadow different eventual outcomes.
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