Publication:

Comorbidity patterns in children aged 6-12 years diagnosed with ADHD in South Kerala: a cross-sectional study

Background Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder of childhood, frequently associated with psychiatric, behavioural, sleep, and learning comorbidities which contribute significantly to functional impairment and complicate management. This study aimed to assess the prevalence of comorbid conditions among children aged 6-9 years diagnosed with ADHD.

Methods A cross-sectional study was conducted among 206 children diagnosed with ADHD using the AIIMS-modified INDT ADHD tool. ADHD subtypes were identified using the Vanderbilt assessment scale-parent informant questionnaire. Sleep problems were assessed using the children’s sleep health questionnaire, epilepsy using the INDT-EPI tool, and specific learning disability using NIMHANS SLD battery. Psychiatric comorbidities were diagnosed based on DSM-5 criteria. Data were analysed using SPSS version 26.

Results The mean age was 7.1±1.0 years, with males constituting 85.4% of participants. The combined ADHD subtype was most prevalent (66.5%), followed by the inattentive (26.2%) and hyperactive/impulsive (7.3%) subtypes. Oppositional defiant disorder was the most common comorbidity (24.8%), followed by specific learning disability (10%), sleep disorders (7.8%) and conduct disorder (7.3%). Academic difficulties were reported in 78% of children. A significant association was observed between ADHD subtypes and both oppositional defiant disorder (p<0.001) and conduct disorder (p<0.05), predominantly in the combined subtype.

Conclusions Children with ADHD, especially the combined subtype, have a high burden of disruptive behaviour and academic comorbidities, underscoring the need for early comprehensive assessment and integrated interventions.