SAN DIEGO – Youth with attention-deficit hyperactivity disorder and a history of major or minor depression reported significantly greater levels of functional impairment, family conflict, and adverse and traumatic life events, compared with ADHD youth who had never been depressed, results from a single-center cross-sectional study showed.
Worse yet, depression appears to be undertreated in ADHD youth who have it, Dr. W. Burleson Daviss said in an interview during a poster session at the annual meeting of the American Academy of Child and Adolescent Psychiatry.
The findings are important because research is limited regarding risk factors for depressive disorders when they occur with ADHD. “The mood disorders kids get when they have ADHD are not unlike the disorders kids get if they don't have ADHD,” said Dr. Daviss of the University of Texas Health Science Center at San Antonio. “They're legitimate diagnoses, and we need to treat them as such.”
He and his associates evaluated 104 patients aged 11–18 years with definitive or probable ADHD, based on Kiddie-Sads-Present and Lifetime Version (K-SADS-PL) interviews.
They divided the young people into three groups: those with a history of minor depression, those with a history of major depression, and those who had never been depressed.
The researchers then compared how the groups responded to a battery of tests, including the Mood and Feelings Questionnaire, the Children's Depression Rating Scale interview, the Clinical Global Impressions Scale of depression, and the Social Adjustment Scale.
Of the 104 youth, more than half (66) were boys and most (83) were white. Dr. Daviss reported that 40 had a history of major depression, 23 had a history of minor depression, and 41 had never been depressed. Subjects with a history of major depressive disorders tended to be older and female.
There were no differences among the three groups in terms of severity of ADHD. Compared with youth who had never been depressed, however, those with a history of major or minor depression reported significantly greater levels of functional impairment, family conflict, and adverse life and traumatic events.
The researchers also observed that the youth with comorbid depression were relatively undertreated for their depression.
“They're seeing their pediatrician or psychiatrist three times over an 8-month period of time for medication checks,” according to Dr. Daviss. “Even the kids with major depression were seeing a therapist only once a month on average. It really is an undertreated group.”
Dr. Daviss acknowledged certain limitations of the study. For example its design was cross-sectional. In addition, the population studied consisted of primarily white, upper-middle-class young people who were referred for treatment.
The study was supported by NARSAD: The Mental Health Research Association and the National Institute of Mental Health.