- 20.7% of 52,098 children with ADHD had comorbid chronic conditions; tic disorder was the most common comorbidity.
- The most frequent comorbidity pair was intellectual disability with autism spectrum disorder, accounting for 25.7% of combined comorbid cases.
- PCA revealed a core comorbidity pattern: tic disorders, intellectual disability, epilepsy, sleep problems and obesity, supporting comprehensive assessment and integrated care.
Front Public Health. 2026 Jul 21;14:1838844. doi: 10.3389/fpubh.2026.1838844. eCollection 2026.
ABSTRACT
OBJECTIVE: This study aims to explore the epidemiological features of medical and psychological comorbidities among children with Attention-Deficit/Hyperactivity Disorder (ADHD) and analyze the comorbidity profiles. The findings are expected to enhance clinical recognition of comorbid conditions and provide evidence for early screening and intervention.
METHODS: A retrospective analysis was performed on children diagnosed with ADHD at Children’s Hospital of Nanjing Medical University between December 2015 and January 2025. Comorbidity was operationalized as ADHD accompanied by at least one other chronic condition or health problem in this study. The 10 most prevalent chronic conditions and health problems were defined based on parental medical history, on-site physical examinations, and blood sample testing. Systematic cluster analysis and principal component analysis (PCA) were employed to explore the comorbidity patterns in children with ADHD.
RESULTS: A total of 52,098 children diagnosed withs ADHD were enrolled in this study, including 41,124 males, accounting for 78.9% of the total study population. The age distribution showed that 92.6% of the children were aged 6-11 years. Among all enrolled subjects, 10,797 children (20.7%) had comorbid chronic conditions or health problems. Tic disorder was the most common comorbid condition. Regarding comorbidity combinations, the most frequent one was the co-occurrence of intellectual disability and autism spectrum disorder (ASD), with a total of 189 cases (n = 189, 25.7%). PCA identified a core comorbidity pattern for ADHD: tic disorders, intellectual disabilities, epilepsy, sleep problems, and obesity.
CONCLUSION: Comorbid conditions are not rare among pediatric ADHD populations. The burden imposed by comorbidity in children with ADHD is substantial and thus cannot be neglected in clinical management. Based on the comorbidity patterns identified in this study, comprehensive clinical assessment covering both ADHD and its potential comorbidities, as well as integrated, individualized intervention strategies, are essential to optimize the long-term outcomes and quality of life for children with ADHD.
PMID:42553683 | PMC:PMC13435844 | DOI:10.3389/fpubh.2026.1838844
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