The characteristics in children with ADHD comorbiding anxiety and depression

Objective To estimate the occurrence of attention deficit hyperactivity disorder comorbiding anxiety and depression and to compare the behavior characteristics of ADHD with and without anxiety or depression.Methods A total of 105 children with ADHD meeting DSM-4 diagnostic criteria aged from 8 to 14 years were involved in this study.They were evaluated with the Screen for Child Anxiety Related Emotional Disorders(SCARED),Depression Self-Rating Scale for Children(DSRSC)by self-report and Achenbach's Child Behavior Checklist(CBCL)by their parents.Another 66(without diagnosis of ADHD)children aged from 8-14 years who were selected from a school as a control group were evaluated too,according to SCARED and DSRSC,a normal group(43 children)was selected from control group for analysis.Results Thirty-nine of 105 children with ADHD compared to 13 of 66 controls scored at or beyond the clinical cut off(25 points)of SCARED score.Thirty-three of 105 children with ADHD compared to 10 of 66(15.2%)controls reached the threshold(15 points)of DSRSC of Chinese Norm(χ2 = 5.704,P = 0.017).In ADHD group 16 of 105(15.2%)ADHD children comorbid both anxiety and depression,but none in controls.In ADHD children,all scores of social ability were lower while all CBCL behavior scores were higher than normal controls except somatic complaint;ADHD with anxiety had higher score in somatic complaint;ADHD with depression had higher score in anxious/depressed and ADHD with both anxiety and depression had higher score in Withdrawn,somatic complaint,Anxious/Depressed,thought problems,attention problems and internalizing problems than ADHD without anxiety and depression.Conclusion The children with ADHD have high occurrence of comorbidity of anxiety and depression.Children comorbided both anxiety and depression have more behavior and internalizing problems,which implies that there is a need for further mental health services for this population.