Comorbid ADHD, PTSD increases psychiatric disorder risk

By Ingrid Grasmo, medwireNews Reporter

Research findings show that comorbid post-traumatic stress disorder (PTSD) in children and young individuals with attention deficit hyperactivity disorder (ADHD) increases the likelihood for psychiatric disorders and psychosocial dysfunction.

The findings, published in Acta Psychiatrica Scandinavica, suggest that among ADHD patients, PTSD is not a result of excessive hyperactive-impulsive or inattentive symptoms and that ADHD symptoms should not be considered a sequelae of PTSD.

"ADHD and PTSD breed true in families and the accumulation of these factors in ADHD and PTSD patients leads to a more severe course and outcome," say Joseph Biederman (Massachusetts General Hospital, Boston, USA) and colleagues in a press statement.

It is hoped that the findings can help clinicians be alert to ways in which children with comorbid ADHD and PTSD may differ from those with ADHD alone, which could impact diagnosis and treatment.

Assessment of psychiatric comorbidity, psychosocial, educational, and cognitive parameters using standardized testing revealed that PTSD was significantly more common among the 271 (5.2%) patients with ADHD compared with the 230 (1.7%) control individuals.

ADHD features were comparable between patients with and without comorbid PTSD, showing similar age at onset; type and average number of ADHD symptoms; and ADHD-associated impairments. This finding suggests that PTSD development in this patient group cannot be simply attributed to higher levels of ADHD symptom domains, say the researchers.

However, ADHD patients with comorbid PTSD had a significantly higher risk for psychiatric hospitalization, school impairment, poorer social functioning, and had a higher prevalence of mood, conduct disorders, and anxiety disorders.

Importantly, the researchers found that onset of ADHD and other comorbidities preceded PTSD, suggesting that they are antecedent risk factors for the development of PTSD in youth, that could be managed through timely identification and management.

Familial risk analysis confirmed that siblings of ADHD patients either with or without comorbid PTSD had a higher prevalence of ADHD compared with control siblings (67 vs 18% and 35 vs 18%, respectively).

Similarly, siblings of patients with comorbid PTSD and ADHD had a significantly higher prevalence of PTSD compared with ADHD and control siblings (20 vs 3 and 3%, respectively).

"Considering the high prevalence of ADHD, and its propensity for impulsivity and accidents, children with ADHD should be considered a high-risk population for the development of PTSD," conclude the authors.

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