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Neurocognitive function in attention-deficit-hyperactivity disorder with and without comorbid disruptive behaviour disorders.
Aust N Z J Psychiatry. 2009 Aug; 43(8):722-30.AN

Abstract

OBJECTIVE

The aim of the present study was to examine the effect of comorbid oppositional defiant disorder (ODD) and conduct disorder (CD) on (i) symptom levels in attention-deficit-hyperactivity disorder (ADHD) and (ii) the relationship between neurocognitive impairment and ADHD symptom severity.

METHOD

A total of 200 6-12-year-old children with DSM-IV ADHD, combined type (ADHD-CT) were identified in a specialist ADHD clinic in metropolitan Melbourne. From this initial group, 23 were identified with ADHD without ODD/CD (ADHD alone), 22 had ADHD and ODD and 20 had ADHD and CD. All the children were medication naive. Twenty-five healthy control children were also recruited from local primary schools. The four groups did not differ in age, gender or full-scale IQ. A cross-sectional study of parent- and teacher-reported ADHD and externalizing symptoms, spatial span, spatial working memory, visuospatial memory, spatial recognition, spatial planning and behavioural inhibition was completed.

RESULTS

Parent-reported externalizing symptoms were higher in the ADHD + CD and ADHD + ODD groups compared to the ADHD alone group. There were no differences in neurocognitive function between children with ADHD-CT with and without ODD or CD. All the ADHD groups, however, performed worse than the healthy control group. Further, worse spatial span, spatial working memory and delayed matching to sample performance were associated with increased teacher-reported ADHD symptoms in the ADHD alone group. Also, worse spatial working memory performance was associated with increased teacher-reported ADHD symptoms in the ADHD + CD group.

CONCLUSIONS

ADHD symptom severity is associated with the magnitude of impairment in executive functions in children with ADHD alone, but these relationships can be obscured by the presence of comorbid disruptive disorders. Children with ADHD + CD may demonstrate similar associations to children with ADHD alone, suggesting a similar underlying dysfunction. ADHD + ODD, however, may be better understood as a maladaptive response to the abnormal behaviours and neurocognitive functions in ADHD.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Barnett R
Academic Child Psychiatry Unit, Royal Children's Hospital, University of Melbourne, Vic, Australia.
Maruff P
No affiliation info available
Vance A
No affiliation info available

MeSH

Attention Deficit Disorder with HyperactivityAttention Deficit and Disruptive Behavior DisordersChildCognitionConduct DisorderFemaleHumansMaleNeuropsychological TestsPsychomotor PerformanceSeverity of Illness Index

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19629793

Citation

Barnett, Rebecca, et al. "Neurocognitive Function in Attention-deficit-hyperactivity Disorder With and Without Comorbid Disruptive Behaviour Disorders." The Australian and New Zealand Journal of Psychiatry, vol. 43, no. 8, 2009, pp. 722-30.
Barnett R, Maruff P, Vance A. Neurocognitive function in attention-deficit-hyperactivity disorder with and without comorbid disruptive behaviour disorders. Aust N Z J Psychiatry. 2009;43(8):722-30.
Barnett, R., Maruff, P., & Vance, A. (2009). Neurocognitive function in attention-deficit-hyperactivity disorder with and without comorbid disruptive behaviour disorders. The Australian and New Zealand Journal of Psychiatry, 43(8), 722-30. https://doi.org/10.1080/00048670903001927
Barnett R, Maruff P, Vance A. Neurocognitive Function in Attention-deficit-hyperactivity Disorder With and Without Comorbid Disruptive Behaviour Disorders. Aust N Z J Psychiatry. 2009;43(8):722-30. PubMed PMID: 19629793.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurocognitive function in attention-deficit-hyperactivity disorder with and without comorbid disruptive behaviour disorders. AU - Barnett,Rebecca, AU - Maruff,Paul, AU - Vance,Alasdair, PY - 2009/7/25/entrez PY - 2009/7/25/pubmed PY - 2009/10/22/medline SP - 722 EP - 30 JF - The Australian and New Zealand journal of psychiatry JO - Aust N Z J Psychiatry VL - 43 IS - 8 N2 - OBJECTIVE: The aim of the present study was to examine the effect of comorbid oppositional defiant disorder (ODD) and conduct disorder (CD) on (i) symptom levels in attention-deficit-hyperactivity disorder (ADHD) and (ii) the relationship between neurocognitive impairment and ADHD symptom severity. METHOD: A total of 200 6-12-year-old children with DSM-IV ADHD, combined type (ADHD-CT) were identified in a specialist ADHD clinic in metropolitan Melbourne. From this initial group, 23 were identified with ADHD without ODD/CD (ADHD alone), 22 had ADHD and ODD and 20 had ADHD and CD. All the children were medication naive. Twenty-five healthy control children were also recruited from local primary schools. The four groups did not differ in age, gender or full-scale IQ. A cross-sectional study of parent- and teacher-reported ADHD and externalizing symptoms, spatial span, spatial working memory, visuospatial memory, spatial recognition, spatial planning and behavioural inhibition was completed. RESULTS: Parent-reported externalizing symptoms were higher in the ADHD + CD and ADHD + ODD groups compared to the ADHD alone group. There were no differences in neurocognitive function between children with ADHD-CT with and without ODD or CD. All the ADHD groups, however, performed worse than the healthy control group. Further, worse spatial span, spatial working memory and delayed matching to sample performance were associated with increased teacher-reported ADHD symptoms in the ADHD alone group. Also, worse spatial working memory performance was associated with increased teacher-reported ADHD symptoms in the ADHD + CD group. CONCLUSIONS: ADHD symptom severity is associated with the magnitude of impairment in executive functions in children with ADHD alone, but these relationships can be obscured by the presence of comorbid disruptive disorders. Children with ADHD + CD may demonstrate similar associations to children with ADHD alone, suggesting a similar underlying dysfunction. ADHD + ODD, however, may be better understood as a maladaptive response to the abnormal behaviours and neurocognitive functions in ADHD. SN - 1440-1614 UR - https://www.unboundmedicine.com/medline/citation/19629793/Neurocognitive_function_in_attention_deficit_hyperactivity_disorder_with_and_without_comorbid_disruptive_behaviour_disorders_ DB - PRIME DP - Unbound Medicine ER -