Evidence map›Paper›PMID 28527021›Full record

ArticleEuropean child & adolescent psychiatry2017

Comorbidity prevalence and treatment outcome in children and adolescents with ADHD.

Laura Reale, Beatrice Bartoli, Massimo Cartabia, Michele Zanetti, Maria Antonella Costantino, Maria Paola Canevini, Cristiano Termine, Maurizio Bonati, Lombardy ADHD Group

Abstract read
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In one paragraph

Article in European child & adolescent psychiatry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 186 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
186citing papers in PubMed, 10 pooled it
15.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

186 citing papers in PubMed, 10 syntheses or guidelines pooled it, 400 citations in OpenAlex.

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126 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Laura RealeLaboratory for Mother and Child Health, Department of Public Health, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. laura.reale@marionegri.it.ORCID http://orcid.org/0000-0003-4904-4293
Beatrice BartoliChild Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy.
Massimo CartabiaLaboratory for Mother and Child Health, Department of Public Health, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Michele ZanettiLaboratory for Mother and Child Health, Department of Public Health, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Maria Antonella CostantinoChild and Adolescent Neuropsychiatric Service, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Maria Paola CaneviniChild Neuropsychiatry Unit, Department of Health Sciences, University of Milan, Milan, Italy.
Cristiano TermineChild Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy.
Maurizio BonatiLaboratory for Mother and Child Health, Department of Public Health, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Lombardy ADHD Group
Mario Negri Institute for Pharmacological Research · ITUniversity of Insubria · ITUniversity of Milan · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Although ADHD comorbidity has been widely studied, some issues remain unsolved. This multicenter observational study aims to examine comorbid psychiatric disorders in a clinical sample of newly diagnosed, treatment naïve children and adolescents with and without ADHD and, to compare treatment efficacy based on the type of comorbidity. We performed an analysis of the medical records of patients identified from the Regional ADHD Registry database, enrolled in 18 ADHD centers in the 2011-2016 period. 1919 of 2861 subjects evaluated (67%) met the diagnostic criteria for ADHD: 650 (34%) had only ADHD, while 1269 (66%) had at least one comorbid psychiatric disorder (learning disorders, 56%; sleep disorders, 23%; oppositional defiant disorder, 20%; anxiety disorders, 12%). Patients with ADHD of combined type and with severe impairment (CGI-S ≥5) were more likely to present comorbidity. 382 of 724 (53%) followed up patients improved after 1 year of treatment. ADHD with comorbidity showed greater improvement when treated with combined interventions or methylphenidate alone. Specifically, combined treatment showed significant superiority for ADHD with learning disorders (ES 0.66) and ODD (ES 0.98), lower for ADHD with sleep or anxiety disorders. Training intervention alone showed only medium efficacy (ES 0.50) for ADHD and learning disorders. This study was the first describing comorbidity patterns of ADHD in Italy, confirming, in a multicenter clinical setting, that ADHD is more often a complex disorder. Findings highlight important diagnostic, therapeutic, and service organization aspects that should be broadly extended to ensure an appropriate and homogenous ADHD management.

Indexed as

AdolescentAttention Deficit Disorder with HyperactivityChildComorbidityFemaleHumansMalePrevalenceTreatment OutcomeAdolescentsAttention deficit hyperactivity disorderChildrenComorbidityTreatment outcome

Identifiers

PMID28527021
OpenAlexW2614422271

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.