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Children With ADHD and Psych Comorbidities at Higher Risk for Schizophrenia
Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and psychiatric comorbidities had a 2-fold higher risk of a subsequent schizophrenia diagnosis compared with those with ADHD and no comorbidities, according to a retrospective cohort study published online in JAMA Network Open.
“These findings highlighted the significance of carefully monitoring psychiatric comorbidities in patients with ADHD to effectively mitigate the burden of schizophrenia,” wrote corresponding author Jin-Won Kwon, PhD, of Kyungpook National University in South Korea, and coauthors.
Researchers analyzed claims data for 211,705 children and adolescents diagnosed with ADHD in Korea between 2010 and 2018. Most were male and between 5- and 9-years-old at the time of diagnosis. Patients were followed through 2019.
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According to the study, the adjusted hazard ratio of receiving a schizophrenia diagnosis was 2.14 in patients with ADHD and psychiatric comorbidity compared with patients with ADHD without psychiatric comorbidity. Researchers noted a progressive increase in schizophrenia risk with increasing numbers of psychiatric comorbidities.
Nearly three-quarters of patients without psychiatric comorbidities at baseline experienced the emergence of other psychiatric disorders before a schizophrenia diagnosis, the study found. Autism spectrum disorder, intellectual disability, tic disorder, depression, and bipolar disorder were the comorbid disorders most associated with increased schizophrenia risk in patients with ADHD.
“These findings are consistent with previous studies that demonstrated a potential positive association between schizophrenia risk and these disorders,” researchers wrote. “…Furthermore, when examining the diagnosis trajectory among patients without psychiatric comorbidities at baseline, these disorders were prominently incident during the follow-up period. These consistent findings across different studies further support the association between these psychiatric comorbidities and increased schizophrenia risk.”
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