ADHD rarely occurs in isolation. Most children and adults with ADHD have one or more co-occurring conditions, which almost always impact treatment and outcomes. “Complex ADHD” is a relatively new term that reflects this phenomenon. Here, learn more about complex ADHD, including how it is diagnosed, and how clinicians should approach treatment.
What is Complex ADHD?
The term “complex ADHD” reflects an evolution in our understanding of the condition, its scope, and its common co-occurrence with one or more psychiatric, learning, or other neurodevelopmental disorders.
Research confirms that attention deficit hyperactivity disorder (ADHD or ADD) commonly co-occurs with other conditions. In fact, we might say this is the rule rather than the exception. As many as 80% of adults with ADHD have at least one coexisting psychiatric disorder, while approximately 60% of children with ADHD have at least one co-occurring condition.
Common conditions co-occurring with ADHD include:
- oppositional defiant disorder (ODD)
- learning disabilities
- mood disorders, including bipolar disorder
- substance use disorders
Complex ADHD & Comorbidities
Apart from conveying comorbidities, the term complex ADHD also describes the condition’s heterogeneity and the variety of factors that can influence its presentation. It also reflects ADHD’s known impact on functioning across many domains of life, especially when symptoms are not adequately treated.
The presence of co-occurring conditions almost always muddles the diagnosis, treatment, and prognosis of ADHD. ADHD and comorbidities may also influence the presentation and severity of one another, which can complicate the detection and treatment of symptoms, and impair overall quality of life. (Serious outcomes are also associated with comorbid conditions. According to one study, mortality risk – already elevated for individuals with ADHD – increases substantially with the number of psychiatric comorbidities.) For all these reasons, recognizing ADHD’s “complexity” is of high clinical importance.
ADHD comorbidities can also change with age.
Understanding Complex ADHD
Although ADHD is associated with various co-occurring conditions, prevalence rates for comorbidities tend to change as an individual ages. For example:
ADHD Comorbidities In Children
- Behavior and conduct problems, like ODD and conduct disorder, occur in about half of children with ADHD, and are not as common in adults with ADHD.
ADHD Comorbidities In Adults
- Anxiety co-occurs with adult ADHD close to half the time. (Rates are lower in children with ADHD).
- Substance use disorder (SUD) – about 25% of adolescents and 50 % of adults are at risk for comorbid substance abuse with ADHD.
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Original article posted by ADDitude Mag.