Comorbi̇di̇ty of attenti̇on defi̇ci̇t hyperacti̇ty di̇sorder subtypes wi̇th anxi̇ety di̇sorder subtypes i̇n a group of chi̇ldren aged 8 to 15 years

Objective: Attention Deficit Hyperactivity Disorder (ADHD) and Anxiety Disorders are the most prevalent psychiatric disorders of childhood. It is well known that Opposite Defiant Disorder (ODD) and Conduct Disorder (CD) is mostly comorbid to ADHD cases. Comorbidity of ADHD and anxiety disorders is also common. According to studies the rate of comorbidity anxiety disorders seen in children with ADHD range from % 20 to % 50. But there are few studies in this field. Also ADHD subtypes (Inattentive Type and ADHD Combined Type ) found to be differentiated and important in anxiety disorder symptoms. Our research aimed to investigate the relationship and comorbidity of anxiety disorder subtype symptoms with newly diagnosed children and adolescents with ADHD. Gender, age, ADHD symptoms assessed with anxiety disorder symptoms compared to healthy comparison Control Group. Method: Our research consisted of 60 treatment naive subjects (36 boys, 24 girls) aged between 8 to 15 years (age range:11,18±2,28) who applied to PEDAM Psychiatry Clinic and MEVA Psychiatry Clinic from 01 January 2015 to 01 June 2015 for the first time and were diagnosed with ADHD according to DSM-IV criteria whose IQ score was above 90. ADHD subtype ( Inattentive type, ADHD Combined Type) diagnosed by clinical observation of child psychiatrists according to DSM-IV criteria. 36 subject (% 60) diagnosed with ADHD Combined Type, 24 subjects (% 40) diagnosed with Inattentive Type. Cases diagnosed with ADHD Hyperactiveİmpulsive Type were excluded from study. % 69,44 of ADHD Combined Type subjects (n:25), %41,6 of Inattentive Type had also comorbid ODD.% 5,5 of ADHD Combined and none of Inattentive group had CD comorbid diagnoses. In all ADHD cases % 58,3 ODD, %3,3 CD comorbidity was found. Subjects were assessed with Socio-demographic İnformation Form, Turgay DSM-IV Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) and Screen for child and Anxiety –Related Emotional Disorders (SCARED). Control Group who had no diagnoses of ADHD (n:66), 29 boys, 37 girls (age range :11,88±2,11 ) was recruited from 239 private college students (from 3rd class to 9th class grade students). Teachers and parents of each college student wanted to complete T-DSM-IV-S. Researcher applied SCARED by asking each student to complete. Results: The Anxiety Disorders comorbidity rate was %56,7 in all ADHD groups, %69,4 in ADHD Combined Type and %37,5 in Inattentive Type. We found ADHD subtype differences for anxiety (Combined vs Inatantive.). Within the ADHD subtypes, anxiety disorders found to be significantly higher in ADHD Combined Type than Inattentive Type (p<0,05). All ADHD subtypes (ADHDCombined Type and ADHD Inattentive Type) did not differ significantly based on gender (p<0,05). All ADHD cases differed significantly in anxiety disorders based on age (p<0,05). 7-11 age group had higher anxiety disorder symptoms than 12-15 age group (p<0,05). Social Anxiety Disorder symptoms was detected in %53,5, Seperation Anxiety Disorder symptoms in %52,3, Generalized Anxiety Disorder symptoms %43,9, Panic Somatic Disorder symptoms in %28,1, School Phobia symptoms in %25,3 of the ADHD cases. Within the ADHD groups more than one anxiety disorder types tend to becomorbid. Discussion: Our results agree with the peviously reported common anxiety comorbidity with ADHD. Within the ADHD subtypes, ADHD Combined Type had significantly higher anxiety symptoms than ADHD Inattentive Tpye. Clinicians should evaluate anxiety symptoms with attention in children with ADHD that could be unnoticed by their parents. Treatment should be determined according to the comorbid anxiety disorder which can be more than one. Key Words: ADHD, Subtype, Anxiety Disorders, Children, Comorbidity.