[go: up one dir, main page]
More Web Proxy on the site http://driver.im/ Skip to main content

Advertisement

Springer Nature Link
Log in

Co-morbidity of adult attention-deficit/hyperactivity disorder with focus on personality traits and related disorders in a tertiary referral center

  • ORIGINAL PAPER
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Objective

The prevalence and consequences of co-morbid axis-I and axis-II disorders as well as personality traits were examined in a large cohort of adult attention-deficit/hyperactivity disorder (AADHD) at a tertiary referral center.

Methods

In- and outpatients referred for diagnostic assessment of AADHD were screened. 372 affected probands were examined by means of the Structured Clinical Interview of DSM-IV axis-I/II disorders, the Revised NEO Personality Inventory (NEO-PI-R), and the Tridimensional Personality Questionnaire (TPQ).

Results

Lifetime co-morbidity with mood disorders was 57.3%, with anxiety disorders 27.2%, and with substance use disorders 45.0%. The histrionic personality disorder (35.2%) was the most frequent personality disorder. AADHD patients exhibited significantly altered scores on most of the NEO-PI-R and TPQ personality dimensions. The extent of substance abuse and dependence, as well as the presence of antisocial personality disorder alone or the cumulative number of other specific personality disorders was associated with lower psychosocial status (p < .0001).

Discussion

In a cohort of patients with AADHD referred to a single tertiary center co-morbidity with axis-I/II disorders was remarkably prevalent. In AADHD co-morbid mood, anxiety, and personality disorders as well as substance abuse/dependence is likely to be predictive of poor outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
£29.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (United Kingdom)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Biederman J, Faraone SV, Monuteaux MC, Bober M, Cadogen E (2004) Gender effects on attention-deficit/hyperactivity disorder in adults, revisited. Biol Psychiatry 55:692–700

    Article  PubMed  Google Scholar 

  2. Biederman J, Faraone SV, Spencer T, Wilens T, Mick E, Lapey KA (1994) Gender differences in a sample of adults with attention deficit hyperactivity disorder. Psychiatry Res 53:13–29

    Article  PubMed  CAS  Google Scholar 

  3. Biederman J, Faraone SV, Spencer T, Wilens T, Norman D, Lapey KA, Mick E, Lehman BK, Doyle A (1993) Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am J Psychiatry 150:1792–1798

    PubMed  CAS  Google Scholar 

  4. Biederman J, Kwon A, Aleardi M, Chouinard VA, Marino T, Cole H, Mick E, Faraone SV (2005) Absence of gender effects on attention deficit hyperactivity disorder: findings in nonreferred subjects. Am J Psychiatry 162:1083–1089

    Article  PubMed  Google Scholar 

  5. Burket RC, Sajid MW, Wasiak M, Myers WC (2005) Personality comorbidity in adolescent females with ADHD. J Psychiatr Pract 11:131–136

    Article  PubMed  Google Scholar 

  6. Chiesa M, Fonagy P (2003) Psychosocial treatment for severe personality disorder. 36-month follow-up. Br J Psychiatry 183:356–362

    Article  PubMed  Google Scholar 

  7. Cloninger CR, Przybeck TR, Svrakic DM (1991) The tridimensional personality questionnaire: U.S. normative data. Psychol Rep 69:1047–1057

    Article  PubMed  CAS  Google Scholar 

  8. Costa PT, McCrae RR (1998) Revised NEO Personality Inventory (NEO PI- R and NEO Five- Factor Inventory (NEO-FFI) professional manual. Psychological Assessment Ressources, Odessa FL

    Google Scholar 

  9. Downey KK, Pomerleau CS, Pomerleau OF (1996) Personality differences related to smoking and adult attention deficit hyperactivity disorder. J Subst Abuse 8:129–135

    Article  PubMed  CAS  Google Scholar 

  10. Downey KK, Stelson FW, Pomerleau OF, Giordani B (1997) Adult attention deficit hyperactivity disorder: psychological test profiles in a clinical population. J Nerv Ment Dis 185:32–38

    Article  PubMed  CAS  Google Scholar 

  11. Faraone SV, Biederman J, Weber W, Russell RL (1998) Psychiatric, neuropsychological, and psychosocial features of DSM-IV subtypes of attention-deficit/hyperactivity disorder: results from a clinically referred sample. J Am Acad Child Adolesc Psychiatry 37:185–193

    Article  PubMed  CAS  Google Scholar 

  12. Fischer M, Barkley RA, Smallish L, Fletcher K (2002) Young adult follow-up of hyperactive children: self-reported psychiatric disorders, comorbidity, and the role of childhood conduct problems and teen CD. J Abnorm Child Psychol 30:463–475

    Article  PubMed  Google Scholar 

  13. Hechtman L, Weiss G (1986) Controlled prospective fifteen year follow-up of hyperactives as adults: non-medical drug and alcohol use and anti-social behaviour. Can J Psychiatry 31:557–567

    PubMed  CAS  Google Scholar 

  14. Jacob CP, Muller J, Schmidt M, Hohenberger K, Gutknecht L, Reif A, Schmidtke A, Mossner R, Lesch KP (2005) Cluster B personality disorders are associated with allelic variation of monoamine oxidase A activity. Neuropsychopharmacology 30:1711–1718

    Article  PubMed  CAS  Google Scholar 

  15. Jacob CP, Strobel A, Hohenberger K, Ringel T, Gutknecht L, Reif A, Brocke B, Lesch KP (2004) Association between allelic variation of serotonin transporter function and neuroticism in anxious cluster C personality disorders. Am J Psychiatry 161:569–572

    Article  PubMed  Google Scholar 

  16. Johann M, Bobbe G, Laufkotter R, Lange K, Wodarz N (2004) Attention-deficit hyperactivity disorder and alcohol dependence: a risk constellation. Psychiatr Prax 31(Suppl 1):102–104

    Article  Google Scholar 

  17. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593–602

    Article  PubMed  Google Scholar 

  18. Kooij JJS, Burger H, Boonstra AM, Van der Linden PD, Kalma LE, Buitelaar JK (2004) Efficacy and safety of methylphenidate in 45 adults with attention-deficit/hyperactivity disorder. a randomized placebo-controlled trial. Psychol Med 34:973–982

    Article  PubMed  CAS  Google Scholar 

  19. Mannuzza S, Klein RG, Abikoff H, Moulton III JL (2004) Significance of childhood conduct problems to later development of conduct disorder among children with ADHD: a prospective follow-up study. J Abnorm Child Psychol 32:565–573

    Article  PubMed  Google Scholar 

  20. Mannuzza S, Klein RG, Bessler A, Malloy P, LaPadula M (1993) Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status. Arch Gen Psychiatry 50:565–576

    PubMed  CAS  Google Scholar 

  21. Mannuzza S, Klein RG, Bessler A, Malloy P, LaPadula M (1998) Adult psychiatric status of hyperactive boys grown up. Am J Psychiatry 155:493–498

    PubMed  CAS  Google Scholar 

  22. Mannuzza S, Klein RG, Bonagura N, Malloy P, Giampino TL, Addalli KA (1991) Hyperactive boys almost grown up. V. Replication of psychiatric status. Arch Gen Psychiatry 48:77–83

    PubMed  CAS  Google Scholar 

  23. Marks DJ, Newcorn JH, Halperin JM (2001) Comorbidity in adults with attention-deficit/hyperactivity disorder. Ann N Y Acad Sci 931:216–238

    Article  PubMed  CAS  Google Scholar 

  24. McGough JJ, Smalley SL, McCracken JT, Yang M, Del’homme M, Lynn DE, Loo S (2005) Psychiatric comorbidity in adult attention deficit hyperactivity disorder: findings from multiplex families. Am J Psychiatry 162:1621–1627

    Article  PubMed  Google Scholar 

  25. Morrison J (1980) Adult psychiatric disorders in parents of hyperactive children. Am J Psychiatry 137:825–827

    PubMed  CAS  Google Scholar 

  26. Murphy K, Barkley RA (1996) Attention deficit hyperactivity disorder adults: comorbidities and adaptive impairments. Compr Psychiatry 37:393–401

    Article  PubMed  CAS  Google Scholar 

  27. Murphy KR, Barkley RA, Bush T (2002) Young adults with attention deficit hyperactivity disorder: subtype differences in comorbidity, educational, and clinical history. J Nerv Ment Dis 190:147–157

    Article  PubMed  Google Scholar 

  28. Nestadt G, Romanoski AJ, Chahal R, Merchant A, Folstein MF, Gruenberg EM, McHugh PR (1990) An epidemiological study of histrionic personality disorder. Psychol Med 20:413–422

    Article  PubMed  CAS  Google Scholar 

  29. Ostendorf F, Angleitner A (2004) NEO-PI-R, Neo-Persönlichkeitsinventar nach Costa und McCrae. Hogrefe-Verlag GmbH Co. KG, Göttingen

    Google Scholar 

  30. Ranseen JD, Campbell DA, Baer RA (1998) NEO-PI-R profiles of adults with attention deficit disorder. Assessment 5:19–24

    Article  PubMed  CAS  Google Scholar 

  31. Rasmussen K, Almvik R, Levander S (2001) Attention deficit hyperactivity disorder, reading disability, and personality disorders in a prison population. J Am Acad Psychiatry Law 29:186–193

    PubMed  CAS  Google Scholar 

  32. Rasmussen P, Gillberg C (2000) Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study. J Am Acad Child Adolesc Psychiatry 39:1424–1431

    Article  PubMed  CAS  Google Scholar 

  33. Reich JH, Green AI (1991) Effect of personality disorders on outcome of treatment. J Nerv Ment Dis 179:74–82

    Article  PubMed  CAS  Google Scholar 

  34. Retz W, Retz-Junginger P, Hengesch G, Schneider M, Thome J, Pajonk FG, Salahi-Disfan A, Rees O, Wender PH, Rosler M (2004) Psychometric and psychopathological characterization of young male prison inmates with and without attention deficit/hyperactivity disorder. Eur Arch Psychiatry Clin Neurosci 254:201–208

    PubMed  Google Scholar 

  35. Rey JM, Morris-Yates A, Singh M, Andrews G, Stewart GW (1995) Continuities between psychiatric disorders in adolescents and personality disorders in young adults. Am J Psychiatry 152:895–900

    PubMed  CAS  Google Scholar 

  36. Robins LN, Helzer JE, Weissman MM, Orvaschel H, Gruenberg E, Burke JD Jr., Regier DA (1984) Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry 41:949–958

    PubMed  CAS  Google Scholar 

  37. Rosler M, Retz W, Retz-Junginger P, Hengesch G, Schneider M, Supprian T, Schwitzgebel P, Pinhard K, Dovi-Akue N, Wender P, Thome J (2004) Prevalence of attention deficit-/hyperactivity disorder (ADHD) and comorbid disorders in young male prison inmates. Eur Arch Psychiatry Clin Neurosci 254:365–371

    Article  PubMed  Google Scholar 

  38. Rosler M, Retz W, Retz-Junginger P, Thome J, Supprian T, Nissen T, Stieglitz RD, Blocher D, Hengesch G, Trott GE (2004) Tools for the diagnosis of attention-deficit/hyperactivity disorder in adults. Self-rating behaviour questionnaire and diagnostic checklist. Nervenarzt 75:888–895

    PubMed  CAS  Google Scholar 

  39. Rutter M (1989) Isle of Wight revisited: twenty-five years of child psychiatric epidemiology. J Am Acad Child Adolesc Psychiatry 28:633–653

    Article  PubMed  CAS  Google Scholar 

  40. Shekim WO, Asarnow RF, Hess E, Zaucha K, Wheeler N (1990) A clinical and demographic profile of a sample of adults with attention deficit hyperactivity disorder, residual state. Compr Psychiatry 31:416–425

    Article  PubMed  CAS  Google Scholar 

  41. Simmons LA, Havens JR (2006) Comorbid substance and mental disorders among rural Americans: Results from the national comorbidity survey. J Affect Disord 99:265–71

    Article  PubMed  Google Scholar 

  42. Sobanski E (2006) Psychiatric comorbidity in adults with attention-deficit/hyperactivity disorder (ADHD). Eur Arch Psychiatry Clin Neurosci 256(Suppl 1):i26–i31

    Article  PubMed  Google Scholar 

  43. Spencer T, Biederman J, Wilens T, Doyle R, Surman C, Prince J, et al. (2005) A large double-blind, randomized trial of methylphenidate in the treatment of adults with attention-deficit / hyperactivity disorder. Biol Psychiatry 57:456–463

    Article  PubMed  CAS  Google Scholar 

  44. Ward MF, Wender PH, Reimherr FW (1993) The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry 150:885–890

    PubMed  CAS  Google Scholar 

  45. Weiss G, Hechtman L (1993) Hyperactive children grown up. Guilford Press, New York

    Google Scholar 

  46. Weiss G, Hechtman L, Milroy T, Perlman T (1985) Psychiatric status of hyperactives as adults: a controlled prospective 15-year follow-up of 63 hyperactive children. J Am Acad Child Psychiatry 24:211–220

    Article  PubMed  CAS  Google Scholar 

  47. Weyers P, Krebs H, Janke W (1998) Reliability and construct validity of the german version of Cloninger‘s tridimensional personality questionnaire. Pers Individ Diff 19:853–861

    Article  Google Scholar 

Download references

Acknowledgments

Supported by the Deutsche Forschungsgemeinschaft (DFG, KFO 125/1-1, SCHA 542/10-2) and Bundesministerium für Bildung und Forschung (NGFN 01GR0460)

Author information

Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University of Wuerzburg, Fuechsleinstr. 15, 97080, Wuerzburg, Germany

    Christian P. Jacob MD, Jasmin Romanos MD, Monika Heine MD, Anja Kruse PhD, Andreas Reif MD, Armin Schmidtke PhD, Jobst Böning MD & Klaus-Peter Lesch MD

  2. Department of Child and Adolescent Psychiatry and Psychotherapy, University of Wuerzburg, Fuechsleinstr. 15, 97080, Wuerzburg, Germany

    Susanne Walitza MD & Marcel Romanos MD

  3. Institute of Medical Biometry and Epidemiology, Philipps-University of Marburg, Bunsenstrasse 3, 35037, Marburg, Germany

    Astrid Dempfle MSc, Christine Windemuth-Kieselbach PhD & Helmut Schäfer PhD

  4. Department of Personality and Individual Differences, Institute of Psychology II, Dresden University of Technology, 01062, Dresden, Germany

    Alexander Strobel PhD & Burkhard Brocke PhD

Authors
  1. Christian P. Jacob MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jasmin Romanos MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Astrid Dempfle MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Monika Heine MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christine Windemuth-Kieselbach PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anja Kruse PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Andreas Reif MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Susanne Walitza MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Marcel Romanos MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Alexander Strobel PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Burkhard Brocke PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Helmut Schäfer PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Armin Schmidtke PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Jobst Böning MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Klaus-Peter Lesch MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christian P. Jacob MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jacob, C.P., Romanos, J., Dempfle, A. et al. Co-morbidity of adult attention-deficit/hyperactivity disorder with focus on personality traits and related disorders in a tertiary referral center. Eur Arch Psychiatry Clin Neurosc 257, 309–317 (2007). https://doi.org/10.1007/s00406-007-0722-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-007-0722-6

Keywords

Search

Navigation