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The following psychiatric disorders frequently occur additionally (comorbidly) in ADHD sufferers, sorted in descending order of frequency in ADHD (in % of ADHD sufferers) versus frequency in non-affected persons.
Adults with the highest 10% of ADHD symptom expression according to ADHD-E were 6.99 times more likely to experience distress due to psychological complaints than those not affected.1
The percentages in the headings indicate the frequency of comorbidity in ADHD. Example: 70 to 80 % of ADHD-affected children suffer from sleep disorders, compared to 35 to 40 % of children without ADHD.
One study found 51.8% of ADHD sufferers had one or more comorbid mental health conditions.2
1.1. Sleep disturbances in children with ADHD - 70 to 80% (vs. 35 to 40%)¶
70 - 80%3; 73.3% (28.5% mild plus 44.8% moderate and severe),45 twice as common as in unaffected children67
For the treatment of sleep disorders ⇒ Sleep problems in ADHD.
A metastudy found ADHD in about 33% of all narcolepsy sufferers at the same time.8
Narcolepsy is associated with decreased levels of dopamine in the cerebrospinal fluid. This is consistent with the dopamine deficiency present in ADHD. In contrast, dogs with narcolepsy were found to have increased levels of dopamine in the amygdala and increased levels of norepinephrine in the oral pontine reticulum. Nevertheless, the dogs respond to stimulants that increase dopamine and norepinephrine.9
For non-affected persons: 2.3 %10
= 5 to 12 times the risk
Nash our experience, the rate of sleep disturbance is significantly higher among adults with ADHD. Of the 670 adult ADHD sufferers (with a medical diagnosis) on the ADxS.org online symptom test, 69% showed sleep problems, compared with 39% among the 159 self-reportedly certainly not affected (as of 03/01/2022).
A metastudy found ADHD in about 33% of all narcolepsy sufferers at the same time.8
Frequent accidents, bumping, bruising. See also under symptoms of ADHD.
2.3. Impaired fine motor skills, poor handwriting - 60%¶
Up to 60% of ADHD sufferers have impaired fine motor skills, such as poor handwriting.13
3. Affective disorders (depression / dysphoria / dysthymia / mania) - 30 to 61 % (vs. 4.7 to 8.9 %)¶
Dysphoria with inactivity is an original ADHD symptom and not a symptom of depression. Antidepressant treatment of dysphoria with inactivity would be malpractice. ⇒ Depression and dysphoria in ADHD
Of 70 adults with ADHD, 60.7% had had an affective disorder in their lifetime, compared with 25.7% of unaffected14
Depression was found in 42.28% (males: 35.60%; females: 40.27%) of adult ADHD sufferers versus 4.69% (males: 3.55%; females: 5.87%) of unaffected, according to a large Swedish cohort study.15, in 29.9% (across the age range) according to another cohort study, and 55.7% gg versus 24.3% in a small study of adults14 16
A simple survey from www.adhs-chaoten.net, in which 73 sufferers took part, revealed that a majority suffer from seasonal autumn-winter depression.20 This is quite regularly the result of a vitamin D3 deficiency. ⇒ Vitamin D3
In adult ADHD sufferers: 61.8%10;
Depression (40 to 60%)21; 25%11
Bipolar disorder (“manic/depressive”): 6%11; (Adults with ADHD total: 6.4%; females 8.3%, males 4.7%; ADHD-I 5.1%, ADHD-C 8.0%, ADHD-HI 10.0%)23 to 4.7% (across age range)16
In adult psychiatric clinical patients with ADHD: 92.2%24
Adults with the highest 10% of ADHD symptom expression according to ADHD-E are 6.68 times more likely to experience burden of depression than unaffected individuals.1
For non-affected persons: 14.3 %10
Major depression (6%)22
= 4 to 5 times the risk
In adult ADHD sufferers with the highest 10% of ADHD symptom expression according to ADHD-E: 6.68 times the risk25
Aggressive behavior is not an original symptom of ADHD-HI. Aggressiveness can be an expression of stress, but not everyone reacts to stress with aggressiveness, nor does everyone tend to externalize stress.
Arguments for pure comorbidity include the fact that ADHD-unspecific medications such as risperidone only reduce aggression, not ADHD symptoms, whereas MPH (methylphenidate) can equally alleviate symptoms of ADHD and ODD.27
Self-regulation deficits of a physiological arousal induced by strong emotions
Difficulty inhibiting inappropriate behavior in response to positive or negative emotions
Problems in refocusing attention when emotions are strong
Disorganization of behavioral coordination in response to emotional activation
DESR is distinct from the persistent and severe aggressive irritability common in pediatric bipolar disorder.31 The abnormal moods of bipolar disorder are not based on poor self-control and include other mood criteria according to DSM-IV.
DESR is not associated with an increased risk of bipolar disorder.25
In studies, 44%25 to 55%32 of ADHD sufferers were found to have DESR, compared to only 2% of non-affected individuals.25
DESR is diagnosed when individuals scored between 180 and 210 on the 3 scales of anxiety/depression (intense emotions), aggression, and attention (impulsivity) of the Child Behavioural Check List (CBCL) (an average of between 60 and 70 per scale). Scores above 210 are no longer referred to as DESR but as more severe forms of affective disorders (disorders of mood and behavioral dysregulation). By the defined diagnostic criteria of DESR, which cannot be achieved without a high score on the aggression scale, the diagnosis of DESR is likely to be limited to the ADHD-HI subtype, which is phenotypically more likely to respond to perceived stress with aggression
The CBCL aggressive behavior scale scores:33
Argues or disagrees a lot
Specifies, cuts to
Is crude or mean to others, intimidates them
Demands much attention
Breaks his own things
Breaks things that belong to parents, siblings or others
Does not obey at home
Disobeys at school
Is easily jealous
Device easily gets into scuffles, altercations
Physically attacks others
Screams a lot
Likes to produce or clown around
Is stubborn, grumpy or irritable, gets easily annoyed by others
Shows sudden changes in mood and emotion
Talks too much
Likes to tease others
Has outbursts of anger or a hot temper
Threatens and bullies others or intimidates them
Is unusually loud
According to our assessment, all question topics primarily target the subtype ADHD-HI (with hyperactivity), whereas only question topics 7, 8, 9, 14 and 15 also fit the subtype ADHD-I, but do not target (its) possible symptoms of an inwardly directed emotional intensity. In the predominantly inattentive subtype (ADHD-I), externalizing symptoms such as aggression or oppositional defiant behavior hardly occur.34 In our understanding, the ADHD-I subtype internalizes perceived stress and does not react primarily aggressively.
DESR can thus only occur in ADHD-HI and ADHD-C sufferers, not in ADHD-I.
We assume that ADHD-I patients also suffer from emotional dysregulation, which just does not or rarely express itself as aggression. This perception was confirmed by an ADHD therapist in a personal interview.
Consequently, significantly more than 44 to 55% of all ADHD sufferers are likely to have emotional dysregulation, although the forms of expression can vary widely
Here, too, studies would be desirable that take into account the subtypes and the phenotypic modes of expression of intense emotions (ADHD-HI: externalizing / ADHD-I: internalizing) for each of these.
5.2. Social Behavior Disorder / Oppositional Defiant Disorder (ODD) / Conduct Disorder (CD) - 26 to 39% (vs. 3.9%)¶
For ADHD affected children: 39.3%32; explicitly for ODD: (35%)19
ODD 26.1% in Iran among children aged 6-18 years.29
For non-affected persons: 3.9 %10
= 10 times the risk
Affected individuals with a social behavior disorder have 21 times the risk (compared to non-affected individuals) of also having ADHD.35
ODD refers primarily to ADHD-HI (with hyperactivity) and less to ADHD-I sufferers (without hyperactivity) because hyperactivity is the outflow of an externalizing stress response pattern, whereas ADHD-I is the outflow of an inwardly directed stress (playing dead, fleeing). ⇒ The subtypes of ADHD: ADHD-HI, ADHD-I, SCT, and others
We understand ODD (Oppositonal Defiant Disorder) as a pure comorbidity to ADHD.
Steinhausen describes social behavior disorders on the one hand as the most common comorbidity of ADHD,36 on the other hand describes the comorbidity on page 174 as a subtype of ADHD.
Apart from the fact that sleep disorders are likely to be significantly more common, we do not consider ODD as a subtype because of the delineability of the genetic basis.
For social behavior disorders as well as ADHD, a special polymorphism of the MAO-A gene is named as a genetic contributor (in each case as one of several interacting special genes). With regard to social behavior disorders, however, this gene polymorphism seems to play a much greater role, since it is mentioned much more frequently there and ADHD can manifest itself even without an involvement of this gene (through interaction of other genes). In ADHD, the MAO-A gene is always mentioned in a subset of affected individuals who also suffer from behavioral disorders.
Further arguing for pure comorbidity is that ADHD-unspecific medications such as risperidone only reduce aggression, not ADHD symptoms, whereas MPH (methylphenidate) can equally alleviate symptoms of ADHD and ODD.27
ODD does not correlate with any of the symptom circuits of the dual / triple pathway model, so has a different neurological basis, at least to that extent.37
More recent definitional models of externalizing aggressive disorder patterns include
Disruptive Mood Dysregulation Disorder (DMDD)38 and
6.1.1. Substance abuse - not elevated to 35% (vs. 3.6%)¶
Substance abuse (SUD) was found in 35.12% (males: 39.44%; females: 30.88%) of adult ADHD sufferers compared with 3.61% (males: 4.40%; females: 2.79%) of nonaffected individuals, according to a large Swedish cohort study.15
A large Norwegian cohort study found no association between ADHD and alcohol or substance abuse,40 as did an earlier study,41, which found increased alcohol and substance abuse in ADHD sufferers only in the presence of additional externalizing disorders.
Substance abuse is a common comorbidity of ADHD.5
Of 70 adults with ADHD, 17.1% had had substance abuse in their lifetime, compared with 2.9% of those unaffected14
SUD sufferers showed an ADHD prevalence of 21%.42
On average, substance abuse begins 3 years earlier in ADHD sufferers43
Appropriate medication (especially methylphenidate) reduces the likelihood of addiction or substance abuse in ADHD.
ADHD sufferers with comorbid cocaine addiction showed a significant reduction in addictive behavior when treated with stimulants, corresponding to a decrease in ADHD symptoms.44
Among adult ADHD sufferers: 40%45 to 42%4647 vs. 26% unaffected (2005),48 thus a 61% increased risk (regardless of medication).
Among adult psychiatric clinical patients with ADHD, 51% are dependent on nicotine.24
In the case of non-affected persons:
27% of women and 32% of men in the total population aged 18 and over49
= 1.6 times the risk
Adults with ADHD-HI: plus 100 % compared to non-affected persons50
ADHD medications, nicotine (smoking), and zinc block the dopamine transporters (DAT) (elevated in ADHD), reducing their overactivity51
In adult ADHD sufferers, between 30%22, 25% to 44%50
where we suspect that these data refer to inpatient psychiatric patients with ADHD.
A large Norwegian cohort study found no association between ADHD and alcohol or substance abuse,40 as did an earlier study,41, which found increased alcohol and substance abuse in ADHD sufferers only in the presence of additional externalizing disorders.
Among adult psychiatric clinical patients with ADHD, one study found alcohol dependence in 4.1%.24
For non-affected persons: 522
= 6 to 8 times the risk
Conversely, among n = 153 alcoholics, 43% were diagnosed with childhood ADHD and 22% with persistent ADHD.52 Another study found an ADHD diagnosis in 19% among 100 adult alcohol abusers in India.53
ADHD was found in 11.2% of all adult addiction patients who used intravenous opioids or intravenous/intranasal benzodiazepines. The ADHD rate was higher in women (15.3%) than in men (10.3%).60
ADHD people are 2 to 3 times more likely to develop substance dependence (addiction) than those who are not affected.61
Those with ADHD are up to 9 times more likely to develop nicotine dependence than those not affected.61
ADHD sufferers are about as likely to be addicted as relatives who are not affected by ADHD.
ADHD sufferers have more than double the risk of developing a gambling addiction (5.3% vs. 2.4%). Problem gambling behavior is 4 times more common among ADHD sufferers (2.4%) than among non-affected persons (0.6%).63
One study found that gene variants that correlate with substance use may causally increase ADHD risk.64
7. Restless Legs (RLS, akathisia) - 20 to 44 % (vs. 2 to 8 %)¶
A study of ADHD-affected children (6 to 16 years) found RLS in 33.3%.65 Other sources speak of 44%.66 A smaller study of adults with ADHD found RLS in 20%, with comorbid RLS complicating ADHD symptoms.67
One study found 10% of ADHD sufferers had a limb periodic movement disorder (PLMS) (greater than 5/hour).68 Another study found 66% of all children with ADHD had a PLM index greater than 5/hour, which is a marker for RLS, while no ADHD nonaffected individuals had an elevated PLM index.69 A metastudy found no evidence of more frequent PLMS in ADHD.70
Among adult psychiatric clinical patients with ADHD, 25.5% showed RLS24
A large cohort study found a strong correlation of restless legs and ADHD.71
Independent of ADHD, RLS occurs in about 2% of all children and adolescents, and in 0.5 to 1% in moderate to severe form. In adults, it affects 5 to 10%. In 25% of those affected, the disorder begins between the ages of 10 and 20.72 Other sources cite a prevalence for RLS of up to 8%.73
In 70% of those affected, one parent is also affected.
A genetic link between RLS and ADHD has not yet been established. An involvement of the BTBD9 gene, which is related to iron stores, would be conceivable.
69.4% of children and adolescents with RLS have sleep disorders (vs. 39.6% of unaffected), 80.6% have a history of “growing pains” (vs. 63.2% of unaffected).73
Common causes of RLS and ADHD
7.1. iron deficiency in RLS and ADHD
There is increasing evidence that iron deficiency (S-ferritin level < 12 ng/ml) underlies common pathophysiological mechanisms in patients with RLS and patients with ADHD-HI73
Iron is a cofactor for tyrosine hydroxylase, an enzyme essential for dopamine synthesis. ADHD and RLS both frequently show decreased iron levels. Lower S-ferritin levels in ADHD sufferers correlate with more severe ADHD-HI symptoms. Children with ADHD and RLS showed lower ferritin levels than children with ADHD without RLS.747576 However, other studies did not find decreased S-ferritin levels in ADHD7778
In RLS, severity correlates more clearly with decreased S-ferritin levels.7980 especially in children.81 It is possible that impaired transport of iron from the serum to the cerebrospinal fluid and of iron to the dopaminergic cells results in decreased cerebral iron levels.82 Adults with RLS show low cerebral iron status.83
Children with ADHD and a predisposition to RLS appear to represent a subgroup at particular risk for severe ADHD-HI symptoms, and iron deficiency may contribute to ADHD symptom severity.74
An RC study found improved ADHD symptoms in children with ADHD and low ferritin levels when iron (80 mg/day) was administered.84
7.2. adenosine for RLS and ADHD
Restless legs could result from downregulation of adenosine A1 receptors as a consequence of iron deficiency.85
Adenosine is closely associated with dopamine. Adenosine receptors are found throughout the brain near dopamine receptors and sometimes form receptor heteromers with them. Adenosine may also be involved in ADHD, although more likely via an exaggerated adenosine action at adenosine A2A receptors. Adenosine inhibits dopamine, adenosine antagonists such as caffeine (coffee, cola, black tea) and theobromine (cocoa) thus increase dopamine.
More about this in the article =&gt Adenosine
7.3. treatment of RLS in ADHD
The problem with the comorbidity of restless legs and ADHD is that ADHD medications (although also dopaminergic) do not work against RLS, and RLS medications such as L-dopa (although also dopaminergic) do not work against ADHD.867387
Prolonged treatment with L-dopa often leads to worsening of RLS symptoms.
It is possible that concomitant administration of L-dopa and stimulants may trigger increased side effects.
A single case report documented a good response of a 6-year-old boy with ADHD and RLS, who was also an MPH nonresponder, to the dopamine agonist ropinirole, in terms of ADHD as well as RLS.88
An anxiety disorder was found in 44.65% (males: 37.02; females: 55.74%) of adult ADHD sufferers compared with 4.89% (males: 3.64%; females: 6.19%) of nonaffected individuals, according to a large Swedish cohort study15
Other sources cite a prevalence of 42% and 20-60%, respectively, among adults with ADHD21; 19% anxiety disorders and 15.5% phobic disorders11
In adult psychiatric clinical patients with ADHD: 25%89 to 28.6%24
Of 70 adults with ADHD, 34.3% had an anxiety disorder in their lifetime, compared with 25.7% of the 70 unaffected14
Anxiety disorders and ADHD seem to reinforce each other. Treatment of anxiety or AD(HS also reduces symptoms of the other disorder.92
Adults with ADHD total: 3.5%; females 2.5%, males 4.4%; ADHD-I 3.3%, ADHD-C 3.0%, ADHD-HI 7.5%23
Of 70 adults with ADHD, 18.6% had social phobia in their lifetime, compared with 10% of the 70 unaffected14
Adults with ADHD total: 1.9%; females 2.9%, males 2.4%; ADHD-I 2.1%, ADHD-C 2.5%, ADHD-HI 7.5%23
Of 70 adults with ADHD, 4.3% had panic disorder in their lifetime, compared with 2.9% of the 70 unaffected14
One metastudy reported that autism spectrum disorders were found in 15% to 21% of children and adolescents with ADHD, and that ADHD-affected children with ASD showed more severe ADHD symptoms than children without ASD.9495
Similarly, 21.6% of autism spectrum disorder sufferers were found to have comorbid ADHD.96 Another source cites 85% comorbid ADHD in ASD sufferers.95
Girls with autism who also had ADHD showed significantly more severe symptoms of ADHD, learning disabilities, and ODD than boys with ASD and ADHD in a large study.97
One cohort study cites 3.6% (across the age range).16
Other sources do not give % figures.598
Source99 DSM-IV still stipulated that ADHD and autism spectrum disorders could not be diagnosed comorbidly. This was changed in DSM 5.
ADHD and ASD share two genes known as risk genes.98 There are considerations that ADHD and autism may have further common genetic roots.100 Among other things, disorders of dopaminergic neurotransmission are suspected in ASD,101 whereas such disorders have been documented in ADHD.
About 50% of those affected by autism have ADHD as a comorbidity.
The fact that according to DSM IV ADHD was not allowed to be diagnosed in autism speaks against empirical experience and is therefore omitted in DSM 5.99
There is evidence that ADHD and autism have common genetic roots.100 Among other things, disorders of dopaminergic neurotransmission are suspected in ASD,102 whereas such disorders are documented in ADHD.
One study found learning-specific partial performance disorders in 6.6% of children between the ages of 7 and 11. Reading disability was found in 4%, dyscalculia in 3.6%, and weakness in written expression in 1.8%. Approximately 63% of children with learning-specific partial performance disorders had one or more comorbid diagnoses, with ADHD being the most common comorbidity at 54.9%. Boys were more frequently affected.104
13.1. Reading disability (dyslexia, dyslexia) - 8 to 40%¶
There is evidence that reading impairment in ADHD shows different connectivity in the brain than reading impairment without ADHD.105
One study found only weak evidence of concordant neurophysiological changes in ADHD and dyslexia.106
65 to 70% of all children with dyslexia are reported to have functional binocular disorders:107
Oculomotor dysfunctions (OMD) (9 %)
Fixation impaired
Consequential movements impaired
Horizontal gaze saccades impaired
Dysfunctional binocular vision (DBS) (16 %)
Heterophoria
Suppression
Convergence insufficiency
Accommodative dysfunction
Fusion insufficiency
Stereopsis insufficient
DBS and OMD (51 %)
Neither DMS nor OMD (24 %)
13.2. Spelling disability (agraphia, dysgraphia) - 12 to 40%¶
12 - 27 %103, 25 - 40 %31, 40 %12
Also in adults with ADHD.108
Bipolar disorder was found in 14.29% (males: 9.95%; females: 18.95%) of adult ADHD sufferers compared with 0.72% (males: 0.53%; females 0.91%) of nonaffected individuals, according to a large Swedish cohort study15
Among adult psychiatric clinical patients with ADHD, another study found a prevalence of 5.1%24
Of 703 adult bipolar sufferers, about 25% had comorbid ADHD, with males and BP type I more likely to have ADHD comorbidity.111 Another study found the likelihood of ADHD increased 3.06-fold in bipolar sufferers. 112
One study found evidence of overlap in the genetic causes of bipolar and ADHD, particularly in early-onset bipolar (under age 21),113 another study also found genetic overlap of bipolar and ADHD.114
In 2.4 million individuals studied, 9250 bipolar disorders were observed. If an ADHD disorder was previously present, the risk of bipolar disorder increased 12-fold over the lifetime; if an ADHD and an anxiety disorder were previously present, the risk increased 30-fold compared to individuals without ADHD and without an anxiety disorder.115
16. Eating Disorders - Loss of Control Eating Syndrome (LOC-ES) - 7.5% to 11.4% (vs. 1.4%)¶
12-fold increased risk in ADHD-HI sufferers.116117
A cohort study of Iranian children and adolescents found an increased prevalence of ADHD in eating disorder sufferers at 7.5%.118
One very large study found ADHD increased the risk of bulimia or anorexia 18.3-fold.119
Of 70 adults with ADHD, 11.4% had social phobia in their lifetime, compared with 1.4% of the 70 unaffected14
For non-affected persons: 0.6 %10
= 50 times the risk
It is not known to us whether they relate these data to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
One study found antisocial personality disorder in 18% of ADHD-HI sufferers with hyperactivity compared with 2% of nonaffected individuals.120.
Other sources cite 37.1%12133 , although we do not know whether these data refer to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
Of 30 ADHD-HI-affected prison inmates, 96% also had antisocial personality disorder.
In contrast, 20 non-prison ADHD-HI sufferers and 18 non-prisoners (without ADHD) were not found to have antisocial personality disorder.Interestingly, amphetamines are the drugs most commonly used by prison inmates affected by ADHD-HI.49 Amphetamines are known to be a highly effective drug for ADHD.
Among domestic violence offenders who had ADHD, ADHD treatment reduced domestic violence far more significantly than did domestic violence interventions.122
35,7 %12133
It is not known to us whether they relate these data to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
In adult psychiatric clinical patients with ADHD: 30.6%24
In adult psychiatric clinical patients with ADHD: 31.6%24
It is not known to us whether these data refer to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
27,1 %12133
It is not known to us whether these data refer to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
40,7 %12133
It is not known to us whether they relate these data to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
In adult psychiatric clinical patients with ADHD: 10.2%24
20,0 %12133
It is not known to us whether these data refer to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
15,7 %12133
It is not known to us whether these data refer to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
In adult psychiatric clinical patients with ADHD: 18.4%24
15,7 %12133
It is not known to us whether these data refer to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
14,3 %12133
It is not known to us whether these data refer to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
8,6 %33
It is not known to us whether these data refer to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
6,4 %33
It is not known to us whether these data refer to ADHD sufferers in general or to ADHD sufferers who are inpatients in a clinic. According to our impression, the latter might be more appropriate.
Decreased cortisol levels have been reported in ADHD in association with aggression disorders.123
Externalizing stress responses are associated with decreased basal cortisol levels and a decreased cortisol response to acute stress.
Disturbances in stress hormone levels, particularly cortisol, are extremely common in ADHD. ⇒ Cortisol in ADHD
19. Impulse control disorder, impulse control disorder - 2.6%¶
One study found 35% of adults with epilepsy also had ADHD.128
In adults with psychogenic nonepileptic seizures (PNES), ADHD was found in 63.6%, whereas in adults with epileptic seizures (ES), ADHD was found in 27.8%.129
Messi syndrome is manifested by a strong urge to collect useless objects with a tendency to litter the living environment. A strong coincidence with ADHD is discussed. Review of the literature in Kuwano et al.130 These found a comorbidity of ADHD in Messi sufferers of 26.7%.
A meta-study of 57 studies found a correlation between ADHD and132
Suicide attempts (OR 2.37)
Suicidal ideation (OR 3.53)
Suicide plans (OR 4.54)
Suicide (OR 6.69).
According to the study, suicide is between 2.37 and 6.69 times more common in ADHD than in non-affected individuals.
Another study found increased suicidality in children and adolescents with ADHD (OR 1.1), but this was mediated by comorbid depression, irritability, and anxiety, not ADHD itself.133
One study examined 450 children. 14% of them chewed their nails. Among these found:135
ADHD at 74.6
Oppositional defiant behavior at 36
Separation anxiety at 20.6
Wetting in 15.6
Tic disorders in 12.7
Obsessive-compulsive disorder at 11.1
mental retardation at 9.5
major depressive disorder in 6.7%
profound developmental disabilities at 3.2%.
39. Mental disorders in relatives of ADHD sufferers¶
An analysis of the entire Taiwanese population in 2010 examined 220,966 parents of children with ADHD-HI (according to ICD-9, which did not know ADHD-I), 174,460 siblings of children with ADHD-HI, and 5,875 children of parents with ADHD-HI. Among these relatives of ADHD-HI sufferers, the risk of severe psychiatric disorders was significantly increased compared with matched controls without relatives with ADHD-HI:136
ADHD-HI: 6.87-fold risk
Autism spectrum disorder: 4.14-fold risk
Bipolar disorder: 2.21-fold risk
Major depressive disorder: 2.08-fold risk
Schizophrenia: 1.69-fold risk
This can be understood as an indication of common genetic causes. Rather theoretically, however, it is also conceivable that this could be explained by immunological consequences of (primarily viral) infections (which are transmitted more frequently among close persons). For this, see the chapter ⇒ Immune system and behavior.
Similarly, similar external life circumstances and similar dysfunctional behavior patterns and stressful experiences are likely to be shared more frequently among close individuals. These mechanisms may complement each other.
Nishino, Sakai (2016): Modulations of Ventral Tegmental Area (VTA) Dopaminergic Neurons by Hypocretins/Orexins: Implications in Vigilance and Behavioral Control In: Monti, Pandi-Perumal, Chokroverty (Herausgeber) (2016): Dopamine and Sleep: Molecular, Functional, and Clinical Aspects, 65-90, 75 ↥
