Childhood trauma in adults with ADHD is associated with comorbid anxiety disorders and functional impairment

Abstract

Background

Child and adolescent psychological trauma exposure is associated with psychopathology in the adult population in general, but literature on childhood trauma (CT) in adults with ADHD is scarce.

Aims

To determine the prevalence of CT among adult patients with ADHD, and whether a history of CT implies different adult outcomes of psychiatric comorbidities, and functional impairment than without.

Method

Previously unmedicated adult outpatients with ADHD (n = 250, median age 32 years) entered the study. Participants were diagnosed with ADHD using the Diagnostic Interview for ADHD in Adults, second edition (DIVA 2.0), and were assessed by historical data, validated questionnaires, and structured clinical interviews for CT and mental disorders including post-traumatic stress disorder (PTSD) and functional impairment. Analyses compared ADHD patients with and without CT.

Results

Prevalence of CT was 44%. Of those with PTSD (n = 21), many had CT (85%, p < 0.001). In binary logistic regression analyses, CT was linked to an increased likelihood of concomitant panic disorder (unadjusted odds ratio, OR = 3.0, p < 0.001, and adjusted OR = 2.7, p < 0.01) and any anxiety disorders and two or more comorbid psychiatric disorders (adjusted OR = 1.9, p < 0.05 and OR = 1.7, p < 0.05, respectively), and was associated with significant functional impairment.

Conclusions

These findings suggest that awareness of child and adolescent trauma is clinically relevant among young to middle-aged adult ADHD patients, and implications for earlier detection of CT and treatment warrant further studies.

Keywords:

• ADHD
• childhood trauma
• comorbidity
• PTSD
• anxiety disorders

Acknowledgments

Dr. Peleikis would like to thank The Department of Psychiatry, Akershus University Hospital, Outpatient Clinic Groruddalen for the disposable and required time for the preparation of this study.

Dr. Fredriksen would like to thank the staff at the outpatient clinic of Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, for their contribution with recruiting and collecting data from patients participating. The authors thank Dr. Christian Reissig at the Division of Mental Health and Addiction, Vestfold Hospital Trust, Norway, for his contribution to the implementation of the diagnostic and evaluation procedures in the study.

Disclosure statement

D.E.P. and M.F. have no interests to disclose. S.V.F. has received grant or research support from the K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, the University of Bergen, Bergen, Norway, the European Union's Seventh Framework Programme for research, technological development, and demonstration, the European Union's Horizon 2020 research and innovation programme, and the National Institute of Mental Health. S.V.F. has received income, potential income, travel expenses, continuing education support, research support from, and/or has served on the advisory boards of/as a consultant to Lundbeck, Rhodes, Arbor, KenPharm, Ironshore, Neurovance, Impact, Takeda, Shire, Akili Interactive Labs, CogCubed, Alcobra, VAYA Pharma, Sunovion, Genomind, and NeuroLifeSciences. In previous years, S.V.F. has received income or research support from Shire, Neurovance, Alcobra, Otsuka, McNeil, Janssen, Novartis, Pfizer, and Eli Lilly and Co. S.V.F. has served as editor of the American Journal of Medical Genetics Part B: Neuropsychiatric Genetics. S.V.F.'s institution (SUNY) has US patent US20130217707 A1 for the use of sodium‐hydrogen exchange inhibitors in the treatment of ADHD. S.V.F. has received royalties from books published by Guilford Press (Straight Talk about Your Child's Mental Health), Oxford University Press (Schizophrenia: The Facts), and Elsevier (ADHD: Non‐Pharmacologic Interventions). S.V.F. has held stock in CogCubed and Ironshore.

Additional information

Funding

D.E.P and M.F. have received no funding for this study. S.V.F. has received funding from the European Union’s Horizon 2020 Research and Innovation Programme grant agreement No 667302.