Mental health disorders often occur with one or more accompanying mental disorders, according to an article by Jennifer Baldwin and Mark Dadds in the "Journal of Abnormal Child Psychology." This co-occurrence of disorders is seen in both children and adults and is especially true with attention-deficit hyperactivity disorder, or ADHD, the researchers note.
Prevalence
ADHD has been estimated to occur between 1 and 20 percent of school-age children, states Guilherme Polanczyk, M.D., and colleagues in "The American Journal of Psychiatry." One explanation for such a wide range in estimation is that the scientific research studies have not standardized the method of measurement across the board, the researchers explain. One study by Rudy Bowen and colleagues, published in 2007 in "Psychiatry Research," found that an anxiety disorder co-occurred in 20 percent of children with ADHD.
Contributing Factors
Some suggest that the prevalence of ADHD is explained by geographic factors. For example, North American children are more likely to have ADHD than their European counterparts, discuss Polanczyk and colleagues. The researchers note that these findings fueled the debate that culture is an important consideration. Another theory is that anxiety contributes to ADHD, as explained by Baldwin and Dadds. The researchers provide the example of a case of a child with anxiety who consequently experiences a lack of concentration and is therefore unable to finish his homework. This outcome, not finishing his homework, is also a behavioral symptom of ADHD.
Treatment
Children with ADHD co-occurring with anxiety respond differently to treatment than do children with ADHD alone, explain Baldwin and Dadds. Therefore, the researchers suggest that treatment should be modified for a child with both disorders. This is one area where caregivers of children with ADHD or anxiety should consult with the child's physician.
Outcomes
ADHD can even act as a catalyst for an anxiety disorder. For example, children with ADHD are more likely to face peer rejection, and such rejection can put children at risk of facing an anxiety disorder, say Baldwin and Dadds. The researchers also explain that children with ADHD tend to have problems with motor control and therefore feel they are less athletically inclined than their peers. Therefore, the researchers suggest that caregivers of children with either disorder should monitor the situation and encourage participation in extra-curricular activities, such as sports, to reduce the chances of a child withdrawing completely from such activities.
Considerations
One notable quality about ADHD with co-occurring anxiety is that one disorder is an internalizing disorder and the other is an externalizing disorder. Particularly, the ADHD is an externalizing disorder, where inappropriate behaviors are expressed outwardly by the person with ADHD, explain Baldwin and Dadd. Anxiety, on the other hand, is an internalizing disorder, where emotions are negative and distorted, as is also true with depression, say the researchers.
References
- "Journal of Abnormal Child Psychology"; Examining Alternative Explanations of the Covariation of ADHD and Anxiety Symptoms in Children: A Community Study; Jennifer S. Baldwin and Mark R. Dadds; January 2008
- "The American Journal of Psychiatry"; The Worldwide Prevalence of ADHD: A Systematic Review and Metaregression Analysis; Guilherme Polanczyk, M.D., et al.; June 2007
- "Psychiatry Research"; Nature of Anxiety Comorbid With Attention Deficit Hyperactivity Disorder in Children From a Pediatric Primary Care Setting; Rudy Bowen et al., January 2007
