Journal of the American Academy of Child & Adolescent Psychiatry
Volume 43, Issue 12 , Pages 1506-1515, December 2004

Attention-Deficit/Hyperactivity Disorder and Comorbidities in 18 Paisa Colombian Multigenerational Families

From the Neurosciences Group, University of Antioquia, Medellín, Colombia (Drs. Palacio, Pineda, Lopera, Arcos-Burgos, Mr. Quiroz, Ms. Henao, Ms. Puerta, Ms. Ramírez); Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Drs. Castellanos, Rapoport); New York University Child Study Center, New York (Dr. Castellanos); Neuropsychology and Conduct Disorder Group and Masteŕs Program of Neuropsychology, University of San Buenaventura, Medellín, Colombia (Dr. Pineda, Ms. Henao, Ms. Puerta); National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (Drs. Arcos-Burgos, Bailey-Wilson, Berg, Muenke).

Accepted 9 July 2004.

ABSTRACT 

Objective:

Eighteen extended multigenerational families were recruited from the genetically isolated Paisa community in Colombia to conduct genetic studies of attention-deficit/hyperactivity disorder (ADHD). This report describes the inclusion strategy and clinical features of participants to facilitate comparisons with other data sets.

Method:

Families were selected through a fixed-sampling scheme beginning with child probands referred for clinical evaluation for ADHD. Direct structured psychiatric interviews were conducted with 433 informative individuals, including 92 children aged 4 to 11, 57 adolescents aged 12 to 17, and 284 adults. Best estimate ADHD diagnoses were established for each informative pedigree member.

Results:

These families contained a high proportion of individuals affected with ADHD (32.8%), which was highly comorbid with conduct disorder (50%; odds ratio 11.5, 95% confidence interval = 6.4–20.9), oppositional defiant disorder (25.4%; odds ratio 2.7, confidence interval = 1.5–4.8), and associated conditions including nicotine dependence and alcohol abuse and/or dependence.

Conclusions:

ADHD in these extended Paisa families is highly comorbid with conduct and oppositional defiant disorders. This pattern of comorbidity, as well as the large dense pedigrees of the sample, suggests that it will be particularly useful for molecular genetic studies that are currently under way.

Key Words:  attention-deficit/hyperactivity disorder , comorbidity , conduct disorder , genetics , phenotype , population isolate

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 This research was supported by the Instituto Colombiano para el Desarrollo de la Ciencia y Tecnología (Colciencias) that funded the project: Fenotipo del Trastorno de la Atención y su Comorbilidad en Familias y en la Población General de una Comunidad Antioqueña, Colciencias Project Code 115-04-12010, grant 115-2002, and by funds provided by the Intramural Research Programs of the National Human Genome Research Institute and the National Institute of Mental Health.Disclosure: Dr. Castellanos received grant support in 2003 and 2004 from McNeil Consumer & Specialty Pharmaceuticals, a Division of McNeil PPC, Inc. The other authors have no financial relationships to disclose.

PII: S0890-8567(09)61384-8

doi:10.1097/01.chi.0000142279.79805.dc

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 43, Issue 12 , Pages 1506-1515, December 2004