Impact of Comorbidity on Three Month Follow-up Outcome of Children with ADHD in a Child Guidance Clinic: Preliminary Report

CONTEXT: Attention deficit hyperactivity disorder (ADHD) is one of the common neurodevelopmental disorders. AIMS: Study objective is to report impact of comorbidities on short-term outcome in children with ADHD followed in a child guidance clinic. SETTINGS AND DESIGN: This was done in a child guidance clinic run jointly by the pediatric and psychiatry department at a tertiary teaching hospital. This is a 3 month prospective follow-up study to assess the outcome in ADHD children. MATERIALS AND METHODS: Children attending pediatric department with behavioral problems or poor scholastic performance were screened for ADHD and further confirmation of diagnosis was done by semistructured interview of the child and parent. Children functional assessment and ADHD symptom profile was compared at baseline and at follow-up. We screened for and excluded those showing autistic spectrum disorder and having worse than mild mental retardation. Baseline variables were compared between improved and not improved subgroups and impact of these variables on outcome at 3-month follow-up was analyzed. STATISTICAL ANALYSIS: Descriptive statistics. RESULTS: Of the 25 children completing the study, at the end of 3 months, 15 improved (not fulfilling criteria for ADHD) and 10 did not improve. Applying Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) for diagnosis of psychiatric comorbidities, six had associated psychiatric comorbidities. This was significantly higher in those who did not improve. CONCLUSIONS: Presence of comorbidities at baseline was found to affect outcome at 3 month assessment in this preliminary study. Future studies with larger sample and longer follow-up are needed for finding the predictors of outcome in ADHD children in developing nations.