Profile of Psychiatric and Non-psychiatric Co-morbidities among Children and Adolescent with ADHD in a Scottish LA Community Child health Clinic

Attention-Deficit/Hyperactivity Disorder (ADHD) is the commonest neurobehavioural disorder diagnosed among children, with up to 50% of them having symptoms persisting into adulthood. There are limited longitudinal studies across the lifespan of children and young people (CYP) with ADHD describing their co-morbidities and quality of life across their lifespan.

Objectives: We aimed to determine the prevalence of Psychiatric and non- psychiatric co-morbidities among CYP with ADHD in a Scottish LA CCH clinic.

Methods: Medical records of all patients seen in the outpatient clinics between June 2016 and May 2017 within NHS Fife was retrospectively reviewed. No identifiable patient record was used and no research ethical approval was required.

Results: A total of 93 out of 543 patients (17%) were diagnosed with ADHD, corresponding to 1.5 per 1000 of children’s population (0-15 yrs), aged between 5 years and 18 years (Average of 11 yrs) and 82% males. Each patient had an average of 2 to 3 other co-morbid neurodevelopmental, psychiatric and non-psychiatric problems (NDPs) (ranging from 1 to 8). The commonest co-morbidities were difficulties with sleep (52%) and behaviour (32%), social communication concerns (24%), and emotional problems (19%).

51 (55%) of ADHD CYP had various non-psychiatric comorbidities including Dyspraxia (25%), sensory difficulties (17%), Dyslexia (12%),Constipation (6.5%), Overweight/Obesity (5%), Hypermobile Joints (4%), Enuresis (4%), Drooling (3%), Asthma (1%) and Attachment difficulties (1%).

Conclusion: There is a high burden of comorbidities among CYP with ADHD, which
requires broad multidisciplinary professional involvement in their management. We conclude that ADHD patients are best managed in within integrated multidisciplinary teams involving Paediatricians, Psychiatrists, Psychologists and other allied health therapists for an optimal outcome and general wellbeing.0p