MYTH: Someone can't have ADD and also have depression, anxiety, or other psychiatric problems.
FACT: A person with ADD is six times more likely to have another psychiatric or learning disorder than most other people. ADD usually overlaps with other disorders.
ADD syndrome is complicated. It includes chronic impairments in multiple cognitive functions. In addition, those with this syndrome often have difficulties with other aspects of their learning, emotional regulation, social functioning, or behavior.
The medical term for a person having more than one disorder is "comorbidity." Sometimes researchers use the term to describe situations where both disorders are present at the same time—for example, within a six- or twelve-month period. Others take "comorbidity" in a more inclusive way to refer to any disorder that occurs within the lifetime of an individual who has a specific disorder.
ADHD has extraordinarily high rates of comorbidity with virtually every other psychiatric disorder listed in the DSM-IV, both in the cross-sectional and lifetime analyses. For example, studies have found that about 5 to 10 percent of children in the general population suffer from anxiety disorders (Tannock 2000). Among children with ADHD, the rate of anxiety disorders is three to six times greater.
In the large Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (MTA Cooperative Group 1999), of chil dren ages seven to nine years diagnosed with ADHD, 70 percent were found to have met DSM-IV diagnostic criteria for at least one other psychiatric disorder within the preceding year. These included:
The MTA sample included only young children; 80 percent were boys and most were in first, second, or third grade during the initial evaluation. Only children with combined-type ADHD were assessed; no children without significant hyperactive-impulsive symptoms of ADHD were included. The profile of psychiatric and learning problems characteristic of older children, adolescents, and adults with ADHD, especially women and those with predominantly inattentive-type ADHD, is likely to be different.
A study of somewhat older children in Puerto Rico yielded results different from the MTA. Among an equal mix of boys and girls ages nine to sixteen years from the general community, Hector Bird and colleagues (1993) found 48 percent who suffered from depressive symptoms, far more than the 4 percent of young children similarly identified in the MTA sample. Some disorders like depression tend to emerge later in life than others.
Studies of adults with ADHD show an even higher incidence of additional disorders accompanying ADHD. Rachel Millstein and others (1997) compared adults whose ADHD symptoms were predominantly inattentive (37 percent) with those who had the combined type (56 percent). Rates for some comorbid disorders were similar between these two subtypes of ADHD; others were different:
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