Prevalence and Factors Associated with Depression among Children and Adolescents with ADHD at Maharaj Nakorn Chiang Mai Hospital
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Published:
Jun 29, 2021
Keywords:
ADHD; depression; prevalence; associated factors
Main Article Content
Abstract
Objective : To study the prevalence and factors associated with depression among children and adolescents with ADHD at Maharaj Nakorn Chiang Mai Hospital.
Method : The research is conducted as a cross-sectional study in children and adolescent who were diagnosed ADHD by DSM-5 criteria between the ages of 7-17 who received treatment at the Children and Adolescent Psychiatric Out-patient Unit, Maharaj Nakorn Chiang Mai Hospital from August 2019 - August 2020. The general information questionnaire, the Thai version of children depression inventory (CDI), and the Thai version of patient health questionnaire-9 (PHQ-9) were used for evaluation. The population characteristics data was then analyzed by percentage, median, and factors associated with depression in children and adolescents with ADHD by using multivariate logistic regression analysis.
Results : Depression was found in 41 children and adolescents with ADHD (32.3%) from 127 participants. 20 patients had mild depression (15.7%), 9 patients had moderate depression (7.1%) and 12 patients had severe depression (9.4%).GPA was found to be significantly associated with depression among children and adolescents with ADHD (p = 0.008).
Conclusion : Children and adolescents with ADHD experience depression more frequently, especially in children who have low academic performance. The prevention, screening and treatment of depression in children and adolescents with early attention should be considered to reduce the cost of long-term treatment and improve the quality of life of children and adolescents with ADHD in the future.
Article Details
How to Cite
Pansri, R., & Charnsil, C. (2021). Prevalence and Factors Associated with Depression among Children and Adolescents with ADHD at Maharaj Nakorn Chiang Mai Hospital. Journal of the Psychiatric Association of Thailand, 66(2), 107–122. Retrieved from https://he01.tci-thaijo.org/index.php/JPAT/article/view/246030
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Original Articles
Articles submitted for consideration must not have been previously published or accepted for publication in any other journal, and must not be under review by any other journal.
References
เอกสารอ้างอิง
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2.Wacharasindhu A, Panyayong B. Psychiatric Disorder in Thai School-Aged Children: I Prevalence. J Med Assoc Thai 2002;85(suppl1): S125-36.
3.Pliszka SR. Patterns of Psychiatric Comorbidity with Attention-Deficit/Hyperactivity Disorder. Child and Adolescent Psychiatric Clinics of North America 2000;9(3):525-40.
4.Daviss W. A Review of Co-Morbid Depression in Pediatric ADHD: Etiologies, Phenomenology, and Treatment. Journal of Child and Adolescent Psychopharmacology 2008;18(6):565-71.
5.Rohde P, Clarke G, Lewinsohn P, Seeley J, Kaufman N. Impact of Comorbidity on a Cognitive-Behavioral Group Treatment for Adolescent Depression. Journal of the American Academy of Child & Adolescent Psychiatry 2001;40(7):795-802.
6.Shroff KP, Sanchez-Lacay JA. Attention deficit hyperactivity disorder in children and adolescents with co-morbid anxiety and depression.Clin Psychol Cog Sci 2018;2(1):21-8.
7.Xia W, Shen L, Zhang J.Comorbid anxiety and depression in school-aged children with attention deficit hyperactivity disorder (ADHD) and self-reported symptoms of ADHD, anxiety, and depression among parents of school-aged children with and without ADHD. Shanghai Arch Psychiatry 2015; 27:356-67.
8.Trani MD, Roma FD, Elda A, Daniela L, Pasquale P, Silvia M, et al. Comorbid Depressive Disorders in ADHD: The Role of ADHD Severity, Subtypes and Familial Psychiatric Disorders. Psychiatry Investigation2014;11(2):137-42.
9.Hassan G, Eissa A, Hwedi D, Hegazy D, Essam A. Children with attention deficit-hyperactivity disorder and comorbid depression. Middle East Current Psychiatry 2013;20(3):140-145.
10. Grover S, Raju VV, Sharma A, Shah R. Depression in Children and Adolescents: A Review of Indian studies. Indian Journal of Psychological Medicine2019;41(3):216-27.
11.Demir T, Karacetin G, Demir D, Uysal O. Epidemiology of depression in an urban population of Turkish children and adolescents. Journal of Affective Disorders 2011;134(1-3):168-176.
12.McCabe M, Ricciardelli L, Banfield S. Depressive Symptoms and Psychosocial Functioning in Preadolescent Children. Depression Research and Treatment 2011;2011:1-7.
13.Angold A, Costello E, Erkanli A. Comorbidity. Journal of Child Psychology and Psychiatry1999;40(1):57-87.
14.Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, et al. Childhood and Adolescent Depression: A Review of the Past 10 Years Part I. Journal of the American Academy of Child & Adolescent Psychiatry 1996;35(11):1427-39.
15.Biederman J, Ball SW, Monuteaux MC, Mick E, Spencer TJ, McCreary M, et al. New Insights Into the Comorbidity Between ADHD and Major Depression in Adolescent and Young Adult Females. Journal of the American Academy of Child & Adolescent Psychiatry 2008;47(4):426-34.
16.Biederman J, Mick E, Faraone SV, Braaten E, Doyle A, Spencer T, et al. Influence of Gender on Attention Deficit Hyperactivity Disorder in Children Referred to a Psychiatric Clinic. American Journal of Psychiatry2002;159(1):36-42.
17.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.5th ed. Arlington VA: American Psychiatric Association; 2013.
18.Mayes SD, Calhoun SL, Chase GA, Mink DM, Stagg RE. ADHD Subtypes and Co-Occurring Anxiety, Depression, and Oppositional-Defiant Disorder: Differences in Gordon diagnostic system and Wechsler working memory and processing speed index scores. Journal of Attention Disorders 2008;12(6):540-50.
19.Nelson J, Gregg N. Depression and Anxiety Among Transitioning Adolescents and College Students With ADHD, Dyslexia, or Comorbid ADHD/Dyslexia. Journal of Attention Disorders 2010;16(3):244-54.
20.Ushijima H, Usami M, Saito K, Kodaira M, Ikeda M. Time course of the development of depressive mood and oppositional defiant behavior among boys with attention deficit hyperactivity disorder: differences between subtypes. Psychiatry Clin Neurosci 2012; 66:285-91.
21.Acosta MT, Castellanos FX, Bolton KL, Balog JZ, Eagen P, Nee L ,et al. Latent Class Subtyping of Attention-Deficit/Hyperactivity Disorder and Comorbid Conditions. Journal of the American Academy of Child & Adolescent Psychiatry 2008;47(7):797-807.
22.MTA Cooperative Group.14 month randomized clinical trial of treatment strategies for children with attention deficit hyperactivity disorder. Arch Gen Psychiatry 1999;56:1073–86.
23.Harpin VA. Medication options when treating children and adolescents with ADHD: interpreting the NICE guidance 2006. Archives of Disease in Childhood - Education and Practice 2008;93(2):58-65.
24.Daviss W, Birmaher B, Diler R, Mintz J. Does Pharmacotherapy for Attention-Deficit/Hyperactivity Disorder Predict Risk of Later Major Depression?. Journal of Child and Adolescent Psychopharmacology 2008;18(3):257-64.
25.Wilens T, Spencer T. The Stimulants Revisited. Child and Adolescent Psychiatric Clinics of North America 2000;9(3):573-603.
26.Pliszka SR. Comorbidity of attention-deficit/hyperactivity disorder with psychiatric disorder: an overview. The Journal of clinical psychiatry 1998;59:50-8.
27.Harris K, Boots M, Talbot J, Vance A. Comparison of Psychosocial Correlates in Primary School Age Children with Attention Deficit/ Hyperactivity Disorder- Combined Type, with and without Dysthymic Disorder. Child Psychiatry and Human Development 2006;36(4):419-26.
28.Puttisri S, Punpanivh P, Pantungtong T ,Sungprasit M. A Depression in Mothers of Children with ADHD. Journal of Psychiatric Association of Thailand 2006; 51(3): 213-23.
29. Faraone SV, Kunwar AR. ADHD in Children With Comorbid Conditions: Diagnosis, Misdiagnosis, and Keeping Tabs on Both[Internet]. Medscape Psychiatry.2020 [cited 2020 November 9]. Available from: https://www.medscape.org/viewarticle/555748_3
30.Nguyen D, Wright E, Dedding C, Pham T, Bunders J. Low Self-Esteem and Its Association With Anxiety, Depression, and Suicidal Ideation in Vietnamese Secondary School Students: A Cross-Sectional Study. Frontiers in Psychiatry 2019;10.
31.Biederman J, Mick E, Faraone SV. Depression in attention defcit hyperactivity disorder (ADHD) children: “true” depression or demoralization? J Afect Disord 1998;47:113-22.
32.Xu F, Cui W, Xing T, Parkinson M. Family Socioeconomic Status and Adolescent Depressive Symptoms in a Chinese Low– and Middle– Income Sample: The Indirect Effects of Maternal Care and Adolescent Sense of Coherence. Frontiers in Psychology 2019;10.
33.Kovacs M. Children’s Depression Inventory.New York: Multi–Health Systems, Inc.; 1992.
34.Trangkasombat U, Likanapichitkul D. The children’s depression inventory as a screen for depression. J Med Assoc Thailand 1997; 30:491-9.
35.Bang Y, Park J, Kim S. Cut-Off Scores of the Children's Depression Inventory for Screening and Rating Severity in Korean Adolescents. Psychiatry Investigation 2015;12(1):23.
36.Kroenke K, Spitzer RL, Williams JB.The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001,16(9):606-13.
37.Lotrakul M, Sumrithe S, Saipanish R. Reliability and validity of the Thai version of the PHQ-9.BMC Psychiatry2008; 8:46.
38. Drabick D, Gadow K, Sprafkin J. Co-occurrence of conduct disorder and depression in a clinic-based sample of boys with ADHD. Journal of Child Psychology and Psychiatry.2006;47(8):766-74.
39. Brunsvold GL, Oepen G, Federman EJ, Akins R. Comorbid Depression and ADHD in Children and Adolescents [Internet]. Psychiatric Times. 2020 [cited 2020 November 9]. Available from: https://www.psychiatrictimes.com/view/comorbid-depression-and-adhd-children-and-adolescents
1.Spetie L,Arnold EL. Attention-Deficit Hyperactivity Disorder. In:Martin A, Bloch M, Volkmar F,editors. Lewis's Child and Adolescent Psychiatry: A Comprehensive Textbook. 5th ed. China: Wolters Kluwer; 2020.p.365-76
2.Wacharasindhu A, Panyayong B. Psychiatric Disorder in Thai School-Aged Children: I Prevalence. J Med Assoc Thai 2002;85(suppl1): S125-36.
3.Pliszka SR. Patterns of Psychiatric Comorbidity with Attention-Deficit/Hyperactivity Disorder. Child and Adolescent Psychiatric Clinics of North America 2000;9(3):525-40.
4.Daviss W. A Review of Co-Morbid Depression in Pediatric ADHD: Etiologies, Phenomenology, and Treatment. Journal of Child and Adolescent Psychopharmacology 2008;18(6):565-71.
5.Rohde P, Clarke G, Lewinsohn P, Seeley J, Kaufman N. Impact of Comorbidity on a Cognitive-Behavioral Group Treatment for Adolescent Depression. Journal of the American Academy of Child & Adolescent Psychiatry 2001;40(7):795-802.
6.Shroff KP, Sanchez-Lacay JA. Attention deficit hyperactivity disorder in children and adolescents with co-morbid anxiety and depression.Clin Psychol Cog Sci 2018;2(1):21-8.
7.Xia W, Shen L, Zhang J.Comorbid anxiety and depression in school-aged children with attention deficit hyperactivity disorder (ADHD) and self-reported symptoms of ADHD, anxiety, and depression among parents of school-aged children with and without ADHD. Shanghai Arch Psychiatry 2015; 27:356-67.
8.Trani MD, Roma FD, Elda A, Daniela L, Pasquale P, Silvia M, et al. Comorbid Depressive Disorders in ADHD: The Role of ADHD Severity, Subtypes and Familial Psychiatric Disorders. Psychiatry Investigation2014;11(2):137-42.
9.Hassan G, Eissa A, Hwedi D, Hegazy D, Essam A. Children with attention deficit-hyperactivity disorder and comorbid depression. Middle East Current Psychiatry 2013;20(3):140-145.
10. Grover S, Raju VV, Sharma A, Shah R. Depression in Children and Adolescents: A Review of Indian studies. Indian Journal of Psychological Medicine2019;41(3):216-27.
11.Demir T, Karacetin G, Demir D, Uysal O. Epidemiology of depression in an urban population of Turkish children and adolescents. Journal of Affective Disorders 2011;134(1-3):168-176.
12.McCabe M, Ricciardelli L, Banfield S. Depressive Symptoms and Psychosocial Functioning in Preadolescent Children. Depression Research and Treatment 2011;2011:1-7.
13.Angold A, Costello E, Erkanli A. Comorbidity. Journal of Child Psychology and Psychiatry1999;40(1):57-87.
14.Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, et al. Childhood and Adolescent Depression: A Review of the Past 10 Years Part I. Journal of the American Academy of Child & Adolescent Psychiatry 1996;35(11):1427-39.
15.Biederman J, Ball SW, Monuteaux MC, Mick E, Spencer TJ, McCreary M, et al. New Insights Into the Comorbidity Between ADHD and Major Depression in Adolescent and Young Adult Females. Journal of the American Academy of Child & Adolescent Psychiatry 2008;47(4):426-34.
16.Biederman J, Mick E, Faraone SV, Braaten E, Doyle A, Spencer T, et al. Influence of Gender on Attention Deficit Hyperactivity Disorder in Children Referred to a Psychiatric Clinic. American Journal of Psychiatry2002;159(1):36-42.
17.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.5th ed. Arlington VA: American Psychiatric Association; 2013.
18.Mayes SD, Calhoun SL, Chase GA, Mink DM, Stagg RE. ADHD Subtypes and Co-Occurring Anxiety, Depression, and Oppositional-Defiant Disorder: Differences in Gordon diagnostic system and Wechsler working memory and processing speed index scores. Journal of Attention Disorders 2008;12(6):540-50.
19.Nelson J, Gregg N. Depression and Anxiety Among Transitioning Adolescents and College Students With ADHD, Dyslexia, or Comorbid ADHD/Dyslexia. Journal of Attention Disorders 2010;16(3):244-54.
20.Ushijima H, Usami M, Saito K, Kodaira M, Ikeda M. Time course of the development of depressive mood and oppositional defiant behavior among boys with attention deficit hyperactivity disorder: differences between subtypes. Psychiatry Clin Neurosci 2012; 66:285-91.
21.Acosta MT, Castellanos FX, Bolton KL, Balog JZ, Eagen P, Nee L ,et al. Latent Class Subtyping of Attention-Deficit/Hyperactivity Disorder and Comorbid Conditions. Journal of the American Academy of Child & Adolescent Psychiatry 2008;47(7):797-807.
22.MTA Cooperative Group.14 month randomized clinical trial of treatment strategies for children with attention deficit hyperactivity disorder. Arch Gen Psychiatry 1999;56:1073–86.
23.Harpin VA. Medication options when treating children and adolescents with ADHD: interpreting the NICE guidance 2006. Archives of Disease in Childhood - Education and Practice 2008;93(2):58-65.
24.Daviss W, Birmaher B, Diler R, Mintz J. Does Pharmacotherapy for Attention-Deficit/Hyperactivity Disorder Predict Risk of Later Major Depression?. Journal of Child and Adolescent Psychopharmacology 2008;18(3):257-64.
25.Wilens T, Spencer T. The Stimulants Revisited. Child and Adolescent Psychiatric Clinics of North America 2000;9(3):573-603.
26.Pliszka SR. Comorbidity of attention-deficit/hyperactivity disorder with psychiatric disorder: an overview. The Journal of clinical psychiatry 1998;59:50-8.
27.Harris K, Boots M, Talbot J, Vance A. Comparison of Psychosocial Correlates in Primary School Age Children with Attention Deficit/ Hyperactivity Disorder- Combined Type, with and without Dysthymic Disorder. Child Psychiatry and Human Development 2006;36(4):419-26.
28.Puttisri S, Punpanivh P, Pantungtong T ,Sungprasit M. A Depression in Mothers of Children with ADHD. Journal of Psychiatric Association of Thailand 2006; 51(3): 213-23.
29. Faraone SV, Kunwar AR. ADHD in Children With Comorbid Conditions: Diagnosis, Misdiagnosis, and Keeping Tabs on Both[Internet]. Medscape Psychiatry.2020 [cited 2020 November 9]. Available from: https://www.medscape.org/viewarticle/555748_3
30.Nguyen D, Wright E, Dedding C, Pham T, Bunders J. Low Self-Esteem and Its Association With Anxiety, Depression, and Suicidal Ideation in Vietnamese Secondary School Students: A Cross-Sectional Study. Frontiers in Psychiatry 2019;10.
31.Biederman J, Mick E, Faraone SV. Depression in attention defcit hyperactivity disorder (ADHD) children: “true” depression or demoralization? J Afect Disord 1998;47:113-22.
32.Xu F, Cui W, Xing T, Parkinson M. Family Socioeconomic Status and Adolescent Depressive Symptoms in a Chinese Low– and Middle– Income Sample: The Indirect Effects of Maternal Care and Adolescent Sense of Coherence. Frontiers in Psychology 2019;10.
33.Kovacs M. Children’s Depression Inventory.New York: Multi–Health Systems, Inc.; 1992.
34.Trangkasombat U, Likanapichitkul D. The children’s depression inventory as a screen for depression. J Med Assoc Thailand 1997; 30:491-9.
35.Bang Y, Park J, Kim S. Cut-Off Scores of the Children's Depression Inventory for Screening and Rating Severity in Korean Adolescents. Psychiatry Investigation 2015;12(1):23.
36.Kroenke K, Spitzer RL, Williams JB.The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001,16(9):606-13.
37.Lotrakul M, Sumrithe S, Saipanish R. Reliability and validity of the Thai version of the PHQ-9.BMC Psychiatry2008; 8:46.
38. Drabick D, Gadow K, Sprafkin J. Co-occurrence of conduct disorder and depression in a clinic-based sample of boys with ADHD. Journal of Child Psychology and Psychiatry.2006;47(8):766-74.
39. Brunsvold GL, Oepen G, Federman EJ, Akins R. Comorbid Depression and ADHD in Children and Adolescents [Internet]. Psychiatric Times. 2020 [cited 2020 November 9]. Available from: https://www.psychiatrictimes.com/view/comorbid-depression-and-adhd-children-and-adolescents