Patterns of symptom presentation of attention-deficit/hyperactivity disorder in children and adolescents attending two tertiary care hospitals in Dhaka city
Keywords:
ADHD, Psychiatric comorbidity, Children and adolescents, Oppositional defiant disorder, Conduct disorderAbstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is frequently associated with psychiatric comorbidities that influence clinical presentation, treatment response, and long-term outcomes. In Bangladesh, data on comorbidity patterns and parental sociodemographic profiles of children with ADHD remain scarce. This study aimed to describe the psychiatric comorbidity patterns in children and adolescents with ADHD attending tertiary care hospitals in Dhaka city, and to examine the distribution of comorbidities by age group and sex. A descriptive cross-sectional study was conducted at two tertiary care hospitals in Dhaka. Fifty children and adolescents aged 5–17 years diagnosed with ADHD using DSM-IV-TR criteria were enrolled using purposive and consecutive sampling. The Bangla validated version of the Development and Well-Being Assessment (DAWBA) was used to generate diagnoses of ADHD and comorbid psychiatric disorders. Parental sociodemographic data were collected using a semi-structured questionnaire. The mean age of children was 9.28 ± 3.13 years, with boys constituting 76.0% of the sample. Most parents resided in urban areas (74.0%) and nuclear families (74.0%); fathers were predominantly service holders (52.0%) and mothers housewives (76.0%). Oppositional defiant disorder (ODD) was the most common comorbidity (38.0%), followed by mental retardation (26.0%) and conduct disorder (24.0%). ODD was more frequent in girls (58.3%) than boys (31.5%). Conduct disorder was present exclusively in boys (31.5%) and was more common in adolescents aged e”11 years (47.0%) than younger children (12.1%). Other comorbidities (phobia, major depressive disorder, separation anxiety disorder, autism spectrum disorder) were rare, each affecting d”2% of the sample. Psychiatric comorbidities, particularly ODD and conduct disorder, are common among children and adolescents with ADHD in Bangladesh, with distinct patterns by sex and age. Clinicians should routinely screen for comorbidities to guide comprehensive treatment planning.
Bang J Psychiatry 2025;39(1): 6-9
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