Personality disorders and Axis I comorbidity in adolescent outpatients with ADHDReportar como inadecuado

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BMC Psychiatry

, 16:175

Personality disorders and disorders of adult behavior


BackgroundAttention deficit hyperactivity disorder ADHD is a lifelong condition which carries great cost to society and has an extensive comorbidity. It has been assumed that ADHD is 2 to 5 times more frequent in boys than in girls. Several studies have suggested developmental trajectories that link ADHD and certain personality disorders. The present study investigated the prevalence of ADHD, common Axis I disorders, and their gender differences in a sample of adolescent outpatients. We also wanted to investigate the relationship between ADHD and personality disorders PDs, as well as how this relationship was influenced by adjustment for Axis I disorders, age and gender.

MethodsWe used a sample consisting of 153 adolescents, aged 14 to 17 years, who were referred to a non-specialized mental health outpatient clinic with a defined catchment area. ADHD, conduct disorder CD and other Axis I conditions were assessed using the Mini International Neuropsychiatric Interview MINI. PDs were assessed using the Structured Interview for DSM-IV Personality SIDP-IV.

Results13.7 % of the adolescents met diagnostic criteria for ADHD, with no significant gender difference. 21.6 % had at least one PD, 17.6 % had CD, and 4.6 % had both ADHD and a PD. There was a significantly elevated number of PD symptoms in adolescents with an ADHD diagnosis p = 0.001, and this relationship was not significantly weakened when adjusted for age, gender and other Axis I disorders p = 0.026. Antisocial χ = 21.18, p = 0.002 and borderline χ = 6.15, p = 0.042 PDs were significantly more frequent in girls than in boys with ADHD.

ConclusionsWe found no significant gender difference in the prevalence of ADHD in a sample of adolescents referred to a general mental health outpatient clinic. Adolescent girls with ADHD had more PDs than boys, with antisocial and borderline PDs significantly different. The present study suggests that ADHD in girls in a general outpatient population may be more prevalent than previously assumed. It especially highlights the importance of assessing antisocial and borderline personality pathology in adolescent girls presenting with ADHD symptoms.

KeywordsADHD Axis I Comorbidity Conduct disorder Personality disorder Adolescent Outpatient AbbreviationsADHDattention deficit hyperactivity disorder

ASPDantisocial personality disorder

BPDborderline personality disorder

CDconduct disorder

ODDoppositional defiant disorder

PDpersonality disorder

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Autor: Hans Ole Korsgaard - Svenn Torgersen - Tore Wentzel-Larsen - Randi Ulberg


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