Behavior Problems and Subtypes of Attention-deficit Hyperactivity Disorder With Comorbidities

This study investigated the relationship between Child Behavior Checklist (CBCL) symptoms and attention-deficit hyperactivity disorder (ADHD) subtypes [inattentive (ADHD-I) and combined (ADHD-C)] with or without comorbidities. Overall, 116 ADHD children were interviewed using the Mini-International Neuropsychiatric Interview to assess ADHD subtypes and comorbidities, and were then divided into four groups according to their subtypes and comorbidities. The CBCL was completed by the parents of the ADHD children. The association between behavioral symptom severity and groups was examined by comparing the CBCL scales of the four groups. The scores for the Aggressive Behavior (p = 0.014) and Anxiety/Depression scales (p = 0.033) were higher in patients with ADHD-I with comorbidities than with ADHD-I without comorbidities. In addition, the score for the Aggressive Behavior scale was higher in patients with ADHD-C without comorbidities than in patients with ADHD-I without comorbidities (p = 0.011). The scores for the six CBCL scales were all higher in patients with ADHD-C with comorbidities than in patients with ADHD-I without comorbidities. Our findings suggest a synergistic effect of the co-occurrence of comorbidities and the ADHD-C subtype on behavioral symptom severity. Physicians could use the CBCL scales to distinguish patients with more severe symptoms from patients with less severe symptoms.