More on Comorbidity in ADD/ADHD: Learning Disabilities, Tourette’s, and more…
This article comes from a subscriber’s question: “are you looking at comorbid conditions such as learning disabilities and Tourette’s that often accompany ADHD?”
To start with, I have reviewed comorbidity and what it means in this article: comorbidity in ADHD.
As a quick review, a comorbid condition is defined as another disorder which is also present when ADHD is there. It causes further morbidity, meaning more difficulties or suffering related to the second disorder.
When someone has ADHD it is very common that they would have a second disorder that affects their functioning. (Or maybe even a third disorder as well…)
Here are some of the common comorbid conditions, and how often they come:
Oppositional defiant disorder occurs in up to 60 percent of kids with ADD or ADHD. This is a behavior disorder characterized by testing limits and disobeying and defying which can be mild or quite severe and interfere with school, home etc. For more information, read this article on Oppositional Defiant Disorder.
Conduct disorder can be up to 25 percent of individuals with ADHD. This is a much more serious behavior disorder where individuals actually test limits to the point that they are crossing the line. These behaviors are severe enough that they would actually be considered criminal behavior. The symptoms include: stealing, setting fires, hurting animals, starting physical fights, bullying others etc.
Mood disorders occur in 20 to 30 percent of individuals with ADD or ADHD; depression much more common. Bipolar disorder is less common but causes a lot of difficulty. A child with bipolar disorder and ADHD can be one of the most difficult children to treat in all of child psychiatry.
Anxiety disorders can be up to 30 percent; that can be Generalized Anxiety Disorder, Separation Anxiety Disorder, Obsessive Compulsive Disorder, Social Anxiety Disorder, etc.
Learning disabilities can occur in 40 percent of people with ADHD or higher. It’s very important to realize that these are separate disorders. The ADHD does not cause the learning disability and the learning disability does not cause the ADHD. So if somebody receives good treatment for their learning disability but still has ADHD there is still interference going on or vice versa if somebody receives good treatment for their ADHD but is not receiving educational help for the learning disability there are still difficulties going on.
A small percentage of kids with ADHD also have Tourette’s (chronic vocal and motor tics) and a small percentage of kids with ADHD would have an autistic spectrum disorder or PDD (pervasive developmental disorder). We’ll cover that in more detail in another article.
So the answer to the question is ‘yes I do look for comorbid conditions such as learning disability and Tourette’s that often accompany ADHD and in fact it’s very important to look for the comorbidity’.
I will say that comorbidity can literally dictate the treatment and outcome for ADHD. By that I mean that simple inattentive ADHD is much easier to treat than ADHD with bipolar disorder for example and the comorbidity can really dictate how things go in the long run.
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Written by Dr. Kenny Handelman - The ADHD Doctor
To find get a FREE special report on ADD/ADHD Medication, visit: Medication Mastery
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May 25th, 2007 at 1:02 pm
My son is eight and has inattentive type ADHD and a non-verbal learning disability (math, spatial relations, sequencing etc). He also happens to be quite gifted in the verbal arena according to his WISC-IV results.
I can certainly vouch for your statement Dr.Handelman that comorbidity contributes to further morbidity. Each condition exacerbates the other. This is definitely the case for my son. It is confusing and stressful to find the right solution to address his challenges and nurture his gifts to give him the very best chance for success in life.
July 20th, 2008 at 2:33 am
Hi Dr. Kenny Handelman,
Your write up on cormobidity is very useful. My neighbour has a son who has ADHD but like some people, she lives in denial and refused to believe there is such a thing as ADHD. With your article, I hope I can persuade her to see the truth that this order exists and that her son may have other disorders as well.