Original articleAdolescents With Attention-Deficit/Hyperactivity Disorder: Adverse Behaviors and Comorbidity
Section snippets
Data source and study cohort
NCS-A was a nationally representative face-to-face survey of 6,483 adolescents aged 13–18 years, conducted in the continental United States [38]. The design and sampling are described in detail elsewhere. Briefly, the NCS-A was based on face-to-face interviews with adolescents and their parents (or parent surrogates). Parents and adolescents were interviewed separately, and their combined responses were used in determining diagnoses. All interviews were conducted using the Composite
Overview
All Odds ratios in primary tables and figures adjust for demographic characteristics (age, sex, and race/ethnicity).
Background characteristics of cohort
Table 1 compares baseline sociodemographic characteristics for youth with and without lifetime ADHD by age group, sex, race/ethnicity, and family income. The ADHD group was significantly more likely than the non-ADHD group to meet the criteria for all four comorbid mental disorder categories. Most of the ADHD sample (69.5%) had at least one comorbid mental disorder.
Lifetime suicidal behaviors
After adjusting
Discussion
In this large nationally representative sample of youth, ADHD was correlated with a range of adverse behaviors. As compared to their peers, adolescents with ADHD had a higher level of impairment in several important domains. Lifetime risks for suicidal behaviors were approximately three times greater for adolescents with ADHD. These teens were also at risk for aggressive behaviors involving physical aggression or property damage with greater than twice the likelihood than non-ADHD teens.
Conclusion
Adolescents with ADHD were found to have had an increased risk of several adverse behaviors previously reported in adults with persistent ADHD. The results offer a broad view of behavioral risks in adolescents with ADHD. Given strong correlations between ADHD and these adverse behaviors and evidence that many continue into adulthood, assessments of ADHD in pediatric primary care settings should include evaluation of these functional domains. Symptom-based evaluations and treatment guidelines do
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Conflicts of interest: Drs Sultan, Hacker, and Olfson and Ms Liu report no conflicts to disclose.