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Commentary on Adhd with Comorbidity

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Natalie Millien


January 12, 2019

Tennille Feldbush

Commentary on ADHD with Comorbidity

Studies have found that there was an increased rate in comorbid substance abuse disorder, anxiety disorder, mood disorder, personality disorders, and disruptive behavior among adults diagnosed with ADHD and it has persisted from their childhood into adulthood. ADHD that did not persist from childhood to adulthood still showed an increased rate of psychiatric comorbidity, (47.3% vs. 84.3%), lower than individuals with persistent ADHD.  Smaller studies report rates of (65-89%) psychiatric comorbidity in adults with ADHD. (Barbaresi, Colligan, Weaver, Voigt, Killian, & Katusic, 2013). It is concerning that among our population-base, there have been found to be a high rate of psychiatric comorbidity in adults with a history of childhood ADHD. The homogeneous population shows better access to medical care minimizing the confounding effects of DHD with comorbidity, compared to the adverse outcome in this cohort of greater populations that bring additional challenges, for example, higher rates of poverty.

ADHD and the estimates of comorbidity, health risk behaviors, and secondary conditions, are very high, ranging from 30% to 60%. It is known that ADHD is a very prevalent childhood disorder that presents comorbid conditions over time with notable social, learning, and psychological impairment. ADHD associated with comorbid conditions and health risk behaviors can increase the chances of poor educational performance, and compromised social amalgamation, and they are often not recognized or managed appropriately, and therefore it comes with more vital social cost and burdens. (Klein, & Biederman, 1999). The high risk of comorbidity should be acknowledged and applied to the diso4der from a public health perspective, followed by secondary conditions, and significant health risk behaviors that arise with impulsive and inattentive behavior.

In the U.S. ADHD occurs in 3% to 5% of the population. Patients with ADHD are high risk for comorbidity, and there should be special consideration in the treatment for the presence of comorbid disorders. (Sherman, & Tarnow, 2013). The rates of comorbidity are equal to or higher in adults than children, though very few studies have tested these exemplary over time in adults. ADHD has been linked with a higher peril for depression and anxiety. The treatment of comorbidities is of great importance. This is because having comorbid psychiatric disorders can cause individuals to have a greater cognitive, social, and psychological impairment, and this is the reason mental health professionals are encouraged to screen for early detection and intervention process. To help the process without concern and commonly used together, are stimulants and antipsychotic medications, despite the fact they are potentially opposing tools. The fact that stimulants and antipsychotic medications have opposing tools of action, according to mainstream psychiatry and psychopharmacology basic research. Stimulants are thought to work by increasing dopamine (DA) levels between neurons, and antipsychotics work by blocking their effects at dopamine receptors. (Yanofski, 2010), "If we are not going to change our practice, can we escape the dilemma by changing our theory?" (para.19).

ADHD has a high rate of being a hereditary neurodevelopmental syndrome with the risk of a lifetime functional impairment. The importance involved with childhood comorbidity has been recognized, and the previous existence of psychopathology is common, though our understanding of psychiatric comorbidity in adults with ADHD is strictly limited with few reports. The differing diagnostic methods, diversity in ADHD nosology, along with the heightened awareness of ADHD steadfastness, advance our appreciation of the relationship that is held between adult ADHD and many other disorders. In practically every study of comorbidity and adult ADHD, some studies may have taken for granted that some comorbidities from lack of follow-ups for some subjects, higher rates are shown in anti-social behavior and substance use disorders as a consistent. (McGough, Smalley, McCracken, Yang, Del'Homme, Lynn, & Loo, 2005).



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