Further Evidence for Family-Genetic Risk Factors in Attention Deficit Hyperactivity Disorder: Patterns of Comorbidity in Probands and Relatives in Psychiatrically and Pediatrically Referred Samples

doi:10.1001/archpsyc.1992.01820090056010

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Vol. 49 No. 9, September 1992

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Further Evidence for Family-Genetic Risk Factors in Attention Deficit Hyperactivity Disorder

Patterns of Comorbidity in Probands and Relatives in Psychiatrically and Pediatrically Referred Samples

Joseph Biederman, MD; Stephen V. Faraone, PhD; Kate Keenan; Jonathan Benjamin, MD; Belinda Krifcher; Cindy Moore; Susan Sprich-Buckminster; Karen Ugaglia; Michael S. Jellinek, MD; Ronald Steingard, MD; Thomas Spencer, MD; Dennis Norman, EdD; Roselyn Kolodny, MD; Ilana Kraus, MD; James Perrin, MD; Martin B. Keller, MD; Ming T. Tsuang, MD, PhD, DSc

Arch Gen Psychiatry. 1992;49(9):728-738.

Abstract

• We examined 140 probands with attention deficit hyperactivitydisorder, 120 normal controls, and their 822 firstdegree relativesusing "blind" raters and structured diagnostic interviews. Comparedwith controls, probands with attention deficit hyperactivitydisorder were more likely to have conduct, mood, and anxietydisorders. Compared with relatives of controls, relatives ofprobands with attention deficit hyperactivity disorder had ahigher risk for attention deficit hyperactivity disorder, antisocialdisorders, major depressive disorder, substance dependence,and anxiety disorders. Patterns of comorbidity indicate thatattention deficit hyperactivity disorder and major depressivedisorders may share common familial vulnerabilities, that attentiondeficit hyperactivity disorder plus conduct disorder may bea distinct subtype, and that attention deficit hyperactivitydisorder and anxiety disorders are transmitted independentlyin families. These results extend previous findings indicatingfamily-genetic influences in attention deficit hyperactivitydisorder by using both pediatrically and psychiatrically referredproband samples. The distributions of comorbid illnesses infamilies provide further validation for subgrouping probandswith attention deficit hyperactivity disorder by comorbidity.

Author Affiliations

From the Pediatric Psychopharmacology Unit, Psychiatry Service (Drs Biederman, Faraone, Jellinek, Steingard, Spencer, Norman, and Keller and Mss Keenan, Krifcher, Moore, Sprich-Buckminster, and Ugaglia) and Children's Service (Drs Jellinek and Perrin), Massachusetts General Hospital, the Department of Pediatrics, Harvard Community Health Plan (Drs Benjamin, Kolodny, and Kraus), Harvard Medical School (Drs Biederman, Benjamin, Faraone, Jellinek, Steingard, Spencer, Norman, Kolodny, Kraus, Perrin, Keller, and Tsuang), and Harvard School of Public Health (Dr Tsuang), Boston; and the Psychiatry Service, Brockton (Mass) Veterans Affairs Medical Center (Drs Faraone and Tsuang). Dr Keller is now with Brown University, Providence, RI.

Footnotes

Accepted for publication July 3, 1991.

Reprint requests to Pediatric Psychopharmacology Unit (ACC 725),Massachusetts General Hospital, Fruit Street, Boston, MA 02114(Dr Biederman).

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