ADHD in developmental age: Comorbidity and treatment outcomes aim

To assess the prevalence rates of neuropsychiatrie comorbidities in children and adolescents with and without ADHD, and compare the effectiveness of treatment in relation to comorbidity. Methods. Clinical data on 378 suspected patients (86% M, 5-17 yr), entered in the Lombardy Region's ADHD Registry in the period 2011-2017 by regional reference center "Medea" of Bosisio Parini (LC), are analyzed to identify: prevalence rates, comparison between prescribed and performed treatments, improvement rates and effectiveness of the treatment in relation to the different therapeutic approaches. Results. 70% (213/306) of first ADHD diagnosis and never treated patients has one (or more) comorbidity: learning disorders (LD) (48%), sleep disturbances (21%), anxiety disorders (16%), intellectual disability (17%), oppositional defiant disorder (12%), language disorders (12%), autism spectrum disorders (10%). Comorbidity is a risk factor for symptom severity (GCI-S Z5). One year after diagnosis, 51% of the population has improved (CGI-l <3). Overall, multi-modal treatment is the most effective for ADHD with other comorbid disorders (Effect Size - ES 0.50) and specifically for ADHD with: LD (ES 0.71), sleep disorders (ES 0.87), anxiety disorders (ES 0.86). Similar efficacy is achieved by child/parent training for ADHD with sleep disorders (ES 0.53) and ADHD with anxiety disorders (ES 0.88). Conclusions. Comorbidity in ADHD is the rule, not the exception. The regional ADHD Registry is a unique tool to agree and share actions for the appropriate management of diagnosis and treatment of ADHD. The results achieved through the application in clinical practice of shared operational lines are highlighted.