ArticlePsychological medicine2014
The effects of temporally secondary co-morbid mental disorders on the associations of DSM-IV ADHD with adverse outcomes in the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A).
Article in Psychological medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
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Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- The role and application of task-state fNIRS in identifying biomarkers in children and adolescents with ADHD: a systematic review.European child & adolescent psychiatry · 2026Pooled it
- ADHD and Suicidality in Adolescents: A Systematic Review of Moderators and Mediators.Clinical child and family psychology review · 2025Pooled it
- Systematic Review: Overlap Between Eating, Autism Spectrum, and Attention-Deficit/Hyperactivity Disorder.Frontiers in psychiatry · 2019Pooled it
- Associations of ADHD genetic risk with objective and subjective economic wellbeing: evidence from Finnish population-based cohorts.Social psychiatry and psychiatric epidemiology · 2026Article
- ADHD classification using spherical phase space partitioning and symbolic time series analysis of multi-channel EEG signals.BMC biomedical engineering · 2026Article
- Reproducible Temperament Profiles in Adolescents With Attention-Deficit/Hyperactivity Disorder Prospectively Predict Clinical Outcomes.Clinical psychological science : a journal of the Association for Psychological Science · 2026Article
- The diagnostic validity of central symptoms for major depressive disorder in adults with attention-deficit/hyperactivity disorder: a network analysis.European archives of psychiatry and clinical neuroscience · 2026Article
- Immediate Effects of Acceptance and Commitment Therapy in Children with ADHD: A Pilot Resting-State fNIRS Study.Brain sciences · 2026Article
- Burden of mental and substance use disorders in China and its provinces, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021.Molecular psychiatry · 2026Article
- Indirect associations between adolescent ADHD and/or oppositional defiant disorder symptoms and adult incomes: the mediating roles of education and co-occurring psychiatric disorders.European child & adolescent psychiatry · 2026Article
- Observational
- The Evolving ADHD Phenotype in the Externalizing Context.The American journal of psychiatry · 2026Review
- From ADHD Diagnosis to Meaning: Does Grief Theory Enhance Our Understanding of Narrative Reconstruction?Brain sciences · 2025Review
- Article
- Effects of Symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) on Academic Performance and Educational Attainment.Child psychiatry and human development · 2025Article
- Maternal exacerbating and protective factors that shape the prevalence and severity of child attention-deficit hyperactivity disorder: a narrative review.Frontiers in psychiatry · 2025Review
- Does age of ADHD medication initiation predict long-term risk of anxiety? A scoping review.PLOS mental health · 2025Article
- Neurobiology of attention-deficit hyperactivity disorder: historical challenges and emerging frontiers.Nature reviews. Neuroscience · 2024Review
- Improved ADHD Diagnosis Using EEG Connectivity and Deep Learning through Combining Pearson Correlation Coefficient and Phase-Locking Value.Neuroinformatics · 2024Article
- Associations of Symptoms of ADHD and Oppositional Defiant Disorder (ODD) in Adolescence With Occupational Outcomes and Incomes in Adulthood.Journal of attention disorders · 2024Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundAlthough DSM-IV attention deficit hyperactivity disorder (ADHD) is known to be associated with numerous adverse outcomes, uncertainties exist about how much these associations are mediated temporally by secondary co-morbid disorders.
methodThe US National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a national survey of adolescents aged 13-17 years (n = 6483 adolescent-parent pairs), assessed DSM-IV disorders with the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Statistical decomposition was used to compare direct effects of ADHD with indirect effects of ADHD through temporally secondary mental disorders (anxiety, mood, disruptive behavior, substance disorders) in predicting poor educational performance (suspension, repeating a grade, below-average grades), suicidality (ideation, plans, attempts) and parent perceptions of adolescent functioning (physical and mental health, interference with role functioning and distress due to emotional problems).
resultsADHD had significant gross associations with all outcomes. Direct effects of ADHD explained most (51.9-67.6%) of these associations with repeating a grade in school, perceived physical and mental health (only girls), interference with role functioning and distress, and significant components (34.5-44.6%) of the associations with school suspension and perceived mental health (only boys). Indirect effects of ADHD on educational outcomes were predominantly through disruptive behavior disorders (26.9-52.5%) whereas indirect effects on suicidality were predominantly through mood disorders (42.8-59.1%). Indirect effects on most other outcomes were through both mood (19.8-31.2%) and disruptive behavior (20.1-24.5%) disorders, with anxiety and substance disorders less consistently important. Most associations were comparable for girls and boys.
conclusionsInterventions aimed at reducing the adverse effects of ADHD might profitably target prevention or treatment of temporally secondary co-morbid disorders.
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Registered trials
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