A Comparative Analysis of Determinants of Family Dynamics of Children with ADHD with and without Comorbid Conduct Disorder

Background: Comorbidity of attention-deficit/hyperactivity disorder (ADHD) is one of the most actively studied topics in the field of child and adolescent psychiatry. Among clinic-referred children, comorbidity is frequently found between ADHD and conduct disorder (CD). However, little is known regarding the probable association between the co-occurrence and external factors. One factor that has recently sparked interest is family dynamics. Objective: To compare the children with attention deficit/ hyperactivity disorder (ADHD)  with and without co-morbid conduct disorder (CD) in terms of selected determinants of family dynamics and the influences of catchment area and gender on these differences. Methodology: This case-control study was conducted upon a sample of 114 pre-diagnosed ADHD children from July 2017 to June 2019 at the Liaquat University Hospital & Sir CJIP. After taking written informed consent from parents of children diagnosed with ADHD, the children were re-evaluated using the Diagnostic & Statistical Manual (DSM) - V criteria. Vanderbilt Parent Rating Scale was also used to screen for possible comorbidities with ADHD. Children with intellectual disability were excluded from the study. Family dynamics like family type, family size, socio-economic status, parental educational and occupational status, family relationships, parental discord, and history of psychiatric illness in family were explored via self-structured interview-based questionnaire. The data obtained was analyzed using SPSS v. 21.0. Results: The cumulative mean age of the sample of ADHD children stood at 7.6 years (SD ± 0.52). Most of the sample of the children hailed from urban (64.3%) areas and were raised in joint families (71.4%). Consanguinity was common among the parents (72.8%) and especially prevalent among the ADHD children with co-morbid CD. The key features that were notably high among families of the children with comorbid CD included positive parental psychiatric history, ADHD among siblings and parental discord. Conclusion: After careful consideration, it can be concluded that consanguinity of parents, joint family system. And family history of psychiatric disorder affects the occurrence of comorbidity of conduct disorder among children with ADHD.