Relationship between ADHD and anxiety in boys: results from a family study.

OBJECTIVE

Recent studies have found an increased risk for both anxiety disorder and attention-deficit hyperactivity disorder (ADHD) in the adult relatives of children with ADHD in comparison with adult relatives of normal controls. Such findings may account for the high rates of comorbid anxiety found in children with ADHD, and they suggest a relationship between the two disorders. However, additional studies are needed to address this relationship that include both anxiety disorder and normal control groups.

METHOD

The first- (n = 239) and second-degree relatives (n = 1,266) of clinically referred boys with ADHD (n = 49), clinically referred boys with anxiety disorder (n = 46), and controls who have never been psychiatrically ill (NPI controls) (n = 37) were assessed with structured interview and diagnosed according to DSM-III-R criteria. Lifetime rates of ADHD and anxiety disorder were then compared for relatives in the three proband groups.

RESULTS

Female relatives of ADHD probands had significantly higher rates of anxiety disorder than female relatives of NPI controls. However, relatives of anxious probands and NPI controls did not differ for ADHD. Furthermore, no evidence of cosegregation of anxiety disorder with ADHD was found in the relatives of probands in the two patient groups.

CONCLUSIONS

ADHD and anxiety may share common risk factors but appear to be independently transmitted in families. The high rate of anxiety in female relatives of ADHD probands was comparable with that found in relatives of anxious probands and warrants further investigation.