Vol. 7, Issue 2, Part C (2025)

Background: Childhood and adolescence are critical periods of human development, but many children and adolescents are vulnerable to neurodevelopmental and psychiatric disorders. Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention and/or hyperactivity-impulsivity that interferes with functioning or development. ADHD is associated with structural, functional, and neurotransmitter alterations in various brain regions, impacting quality of life and posing an economic burden to affected individuals, families, and healthcare systems. The etiology of most ADHD cases is multifactorial, involving genetics, environmental influences, and social factors. ADHD frequently co-occurs with other psychiatric disorders, complicating management.
Objective: To identify psychiatric comorbidities among children and adolescents with ADHD.
Materials and Methods: This descriptive, cross-sectional study was conducted from May 2018 to September 2020 at the Department of Psychiatry, BSMMU. A total of 47 children and adolescents aged 5-19 years with ADHD attending the outpatient department were enrolled using purposive and consecutive sampling. Socio-demographic and related variables were collected via face-to-face interviews. Psychiatric comorbidities were assessed using the Development and Well-Being Assessment (DAWBA), and diagnoses were confirmed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Ethical approval was obtained from the Institutional Review Board of BSMMU.
Results: The mean age of participants was 12.8±3.1 years, with 25.5% aged 5-9 years and 40.4% aged 10-14 years. Male-to-female ratio was 4.8:1. ADHD subtypes included combined type (68%), hyperactive/impulsive type (19.1%), and inattentive type (12.7%). Overall, 57.4% of participants had at least one comorbid psychiatric disorder. Among these, 62.9% had a single comorbidity and 37% had multiple comorbidities. The most common comorbidities were Oppositional Defiant Disorder (44.4%), Conduct Disorder (29.6%), obsessive-compulsive disorder (25.9%), Intellectual Disability (18.5%), and autism spectrum disorder (11.1%). Significant risk factors included male gender (64.1%), advanced maternal age (32.6 ± 11.2 years), low income (57.4%), irregular antenatal care, multiparity (56%), history of mental illness, birth complications including asphyxia (25.5%) and injury (17%).
Conclusion: Children and adolescents with ADHD have a high prevalence of psychiatric comorbidities. Recognizing these comorbidities is essential for targeted interventions and improving outcomes in this population.