Jefferson Prince, MD, Thomas A. M. Kramer, MD, Jane Feldman, MD

Disclosures

March 26, 2003

In This Article

Comorbidity

Comorbidity with other psychiatric disorders is often an issue with ADHD, but it is of particular concern in adolescents with ADHD. Depression, mania, and anxiety disorders can present during this time. These comorbid disorders are often difficult to recognize in adolescents with persistent ADHD. The parents and teachers of these patients are all used to looking through the "ADHD lens" at these adolescents and may miss the comorbid disorder. In patients being evaluated for the first time for ADHD during their adolescence, these comorbid conditions must be considered within the differential diagnosis. Of particular concern with adolescents with ADHD is tobacco use. Patients with ADHD start using tobacco 2 years earlier than their non-ADHD peers and have a more difficult time quitting. In addition, potential for substance abuse needs to be actively monitored by the clinician. In particular, recreational drugs such as alcohol or marijuana may be of particular risk in those patients who may be getting anxiety side effects from stimulant medication and abusing those substances in order to calm themselves down. Adolescence is also the period of life in which most eating disorders present, and the anorexia that can be caused as a side effect of ADHD medication can either elicit or exacerbate an eating disorder. Anxiety is another stimulant side effect that can either elicit or exacerbate a comorbid disorder.

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