Peer-reviewed article
Psychiatric Comorbidities in 7-12 Year Old Children Diagnosed With ADHD in South Africa: A Record Review.
Sathekge T, Bruton M, Godwin E, Gouws M, Grobler H et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined psychiatric conditions occurring alongside ADHD in 108 South African children aged 7-12 years using hospital records from 2020-2022. Almost all children had at least one additional psychiatric condition, most commonly anxiety disorder, intellectual disability, and oppositional defiant disorder. The rates of comorbidities were higher than international figures, and many children experienced domestic violence or had parents with substance abuse or mental health problems. The authors recommend comprehensive and trauma-informed assessment approaches.
Key points
- 95.5% of children with ADHD had at least one psychiatric comorbidity
- Generalised anxiety disorder was most common (52.8%), followed by intellectual disability (38.9%) and oppositional defiant disorder (29.6%)
- Comorbidity rates exceeded international estimates
- 29.6% of children experienced domestic violence; 33.3% had parents with substance abuse; 30.6% had parents with psychiatric history
- Combined ADHD subtype was most prevalent (72.2%)
Limitations
This is a retrospective record review from a single hospital in one city, so findings may not represent all South African children with ADHD or other settings. The study does not establish whether comorbidities caused the higher rates or how they should be treated.
Abstract
BackgroundADHD is a prevalent neurodevelopmental disorder frequently accompanied by psychiatric comorbidities. While international evidence is well-established, data from South Africa - particularly in younger children - remain limited.AimTo describe psychiatric comorbidities and associated factors in children aged 7-12 years with primary ADHD at the Child, Adolescent, and Family Unit (CAFU), Charlotte Maxeke Johannesburg Academic Hospital (CMJAH).MethodsA retrospective cross-sectional record review of children aged 7-12 years with primary ADHD at CAFU between January 2020 and December 2022. Data were analysed using SPSS version 26.ResultsOf 573 records screened, 108 were included. The combined subtype was most prevalent (72.2%). Almost all children (95.5%) had at least one comorbidity. The most frequent were generalised anxiety disorder (52.8%), intellectual disability (38.9%), and oppositional defiant disorder (29.6%). Females were more likely to present with oppositional defiant disorder (p = .007) and males with autism spectrum disorder (p = .032). High rates of domestic violence (29.6%), parental substance abuse (33.3%), and parental psychiatric history (30.6%) were documented.ConclusionPsychiatric comorbidities are highly prevalent in South African children with ADHD, exceeding international estimates, and reflect the broader psychosocial context of the setting. Comprehensive, multidisciplinary, and trauma-informed assessments are essential.