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Co-transmission of conduct problems with attention-deficit/hyperactivity disorder: familial evidence for a distinct disorder

Co-transmission of conduct problems with attention-deficit/hyperactivity disorder: familial evidence for a distinct disorder
Co-transmission of conduct problems with attention-deficit/hyperactivity disorder: familial evidence for a distinct disorder
Common disorders of childhood and adolescence are attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD). For one to two cases in three diagnosed with ADHD the disorders may be comorbid. However, whether comorbid conduct problems (CP) represents a separate disorder or a severe form of ADHD remains controversial. We investigated familial recurrence patterns of the pure or comorbid condition in families with at least two children and one definite case of DSM-IV ADHDct (combined-type) as part of the International Multicentre ADHD Genetics Study (IMAGE). Using case diagnoses (PACS, parental account) and symptom ratings (Parent/Teacher Strengths and Difficulties [SDQ], and Conners Questionnaires [CPTRS]) we studied 1009 cases (241 with ADHDonly and 768 with ADHD + CP), and their 1591 siblings. CP was defined as ?4 on the SDQ conduct-subscale, and T ? 65, on Conners’ oppositional-score. Multinomial logistic regression was used to ascertain recurrence risks of the pure and comorbid conditions in the siblings as predicted by the status of the cases. There was a higher relative risk to develop ADHD + CP for siblings of cases with ADHD + CP (RRR = 4.9; 95%CI: 2.59–9.41); p < 0.001) than with ADHDonly. Rates of ADHDonly in siblings of cases with ADHD + CP were lower but significant (RRR = 2.9; 95%CI: 1.6–5.3, p < 0.001). Children with ADHD + CP scored higher on the Conners ADHDct symptom-scales than those with ADHDonly. Our finding that ADHD + CP can represent a familial distinct subtype possibly with a distinct genetic etiology is consistent with a high risk for cosegregation. Further, ADHD + CP can be a more severe disorder than ADHDonly with symptoms stable from childhood through adolescence. The findings provide partial support for the ICD-10 distinction between hyperkinetic disorder (F90.0) and hyperkinetic conduct disorder (F90.1).
adhd, conduct problems, conduct disorder, comorbidity, diagnosis, oppositional defiant disorder, relative risk
0300-9564
13pp
Christiansen, H.
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Chen, W.
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Oades, R.D.
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Asherson, P.
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Taylor, E.A.
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Lasky-Su, J.
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Zhou, K.
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Banaschewski, T.
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Buschgens, C.
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Franke, B.
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Gabriels, I.
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Marnor, I.
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Marco, R.
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Müller, U.C.
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Mulligan, A.
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Psychogiou, L.
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Rommelse, N.N.J.
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Uebel, H.
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Buitelaar, J.
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Ebstein, R.P.
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Eisenberg, J.
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Gill, M.
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Miranda, A.
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Mulas, F.
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Roeyers, H.
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Rothenberger, A.
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Sergeant, J.A.
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Sonuga-Barke, E.J.S.
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Steinhausen, H.-C.
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Thompson, M.
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Faraone, S.V.
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Christiansen, H.
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Chen, W.
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Oades, R.D.
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Asherson, P.
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Taylor, E.A.
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Lasky-Su, J.
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Zhou, K.
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Banaschewski, T.
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Buschgens, C.
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Franke, B.
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Gabriels, I.
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Marnor, I.
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Marco, R.
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Müller, U.C.
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Mulligan, A.
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Psychogiou, L.
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Rommelse, N.N.J.
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Uebel, H.
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Buitelaar, J.
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Ebstein, R.P.
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Eisenberg, J.
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Gill, M.
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Miranda, A.
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Mulas, F.
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Roeyers, H.
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Rothenberger, A.
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Sergeant, J.A.
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Sonuga-Barke, E.J.S.
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Steinhausen, H.-C.
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Thompson, M.
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Faraone, S.V.
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Christiansen, H., Chen, W., Oades, R.D., Asherson, P., Taylor, E.A., Lasky-Su, J., Zhou, K., Banaschewski, T., Buschgens, C., Franke, B., Gabriels, I., Marnor, I., Marco, R., Müller, U.C., Mulligan, A., Psychogiou, L., Rommelse, N.N.J., Uebel, H., Buitelaar, J., Ebstein, R.P., Eisenberg, J., Gill, M., Miranda, A., Mulas, F., Roeyers, H., Rothenberger, A., Sergeant, J.A., Sonuga-Barke, E.J.S., Steinhausen, H.-C., Thompson, M. and Faraone, S.V. (2008) Co-transmission of conduct problems with attention-deficit/hyperactivity disorder: familial evidence for a distinct disorder. Journal of Neural Transmission, 13pp. (doi:10.1007/s00702-007-0837-y).

Record type: Article

Abstract

Common disorders of childhood and adolescence are attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD). For one to two cases in three diagnosed with ADHD the disorders may be comorbid. However, whether comorbid conduct problems (CP) represents a separate disorder or a severe form of ADHD remains controversial. We investigated familial recurrence patterns of the pure or comorbid condition in families with at least two children and one definite case of DSM-IV ADHDct (combined-type) as part of the International Multicentre ADHD Genetics Study (IMAGE). Using case diagnoses (PACS, parental account) and symptom ratings (Parent/Teacher Strengths and Difficulties [SDQ], and Conners Questionnaires [CPTRS]) we studied 1009 cases (241 with ADHDonly and 768 with ADHD + CP), and their 1591 siblings. CP was defined as ?4 on the SDQ conduct-subscale, and T ? 65, on Conners’ oppositional-score. Multinomial logistic regression was used to ascertain recurrence risks of the pure and comorbid conditions in the siblings as predicted by the status of the cases. There was a higher relative risk to develop ADHD + CP for siblings of cases with ADHD + CP (RRR = 4.9; 95%CI: 2.59–9.41); p < 0.001) than with ADHDonly. Rates of ADHDonly in siblings of cases with ADHD + CP were lower but significant (RRR = 2.9; 95%CI: 1.6–5.3, p < 0.001). Children with ADHD + CP scored higher on the Conners ADHDct symptom-scales than those with ADHDonly. Our finding that ADHD + CP can represent a familial distinct subtype possibly with a distinct genetic etiology is consistent with a high risk for cosegregation. Further, ADHD + CP can be a more severe disorder than ADHDonly with symptoms stable from childhood through adolescence. The findings provide partial support for the ICD-10 distinction between hyperkinetic disorder (F90.0) and hyperkinetic conduct disorder (F90.1).

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Published date: 17 January 2008
Additional Information: Online First publication
Keywords: adhd, conduct problems, conduct disorder, comorbidity, diagnosis, oppositional defiant disorder, relative risk

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Local EPrints ID: 50229
URI: https://eprints.soton.ac.uk/id/eprint/50229
ISSN: 0300-9564
PURE UUID: 49aad6e2-8e90-4ddd-8a74-48dd5652f729

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Date deposited: 30 Jan 2008
Last modified: 13 Mar 2019 20:52

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Contributors

Author: H. Christiansen
Author: W. Chen
Author: R.D. Oades
Author: P. Asherson
Author: E.A. Taylor
Author: J. Lasky-Su
Author: K. Zhou
Author: T. Banaschewski
Author: C. Buschgens
Author: B. Franke
Author: I. Gabriels
Author: I. Marnor
Author: R. Marco
Author: U.C. Müller
Author: A. Mulligan
Author: L. Psychogiou
Author: N.N.J. Rommelse
Author: H. Uebel
Author: J. Buitelaar
Author: R.P. Ebstein
Author: J. Eisenberg
Author: M. Gill
Author: A. Miranda
Author: F. Mulas
Author: H. Roeyers
Author: A. Rothenberger
Author: J.A. Sergeant
Author: E.J.S. Sonuga-Barke
Author: H.-C. Steinhausen
Author: M. Thompson
Author: S.V. Faraone

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