What is Complex ADHD?
Complex ADHD is specifically defined by the Society for Developmental and Behavioral Pediatrics (SDBP) as ADHD co-occurring with one or more learning, neurodevelopmental, or psychiatric disorders. The adjective “complex” refers not only to the particular co-morbid conditions but also the large variety of factors that can affect how these manifest in any given individual.
The term has come into greater use as the medical community has recognized how common comorbid conditions are in those with ADHD, and treatment guidelines have been updated to include these as part of the evaluation and diagnosis of ADHD.
Some of the most
- Tourette’s syndrome
- oppositional defiant disorder
- learning disabilities
- mood disorders, e.g., bipolar disorder
- substance abuse problems
The Patterns of Complex ADHD
The prevalence of co-morbid conditions is high. Up to 75% of pediatric patients with ADHD have a co-morbid psychiatric condition. And approximately 60% of children diagnosed with ADHD fit into the complex category.
Shared genetic and neurological underpinnings between ADHD and these co-occurring conditions are believed to be responsible for these high rates.
The presentation of these conditions can change depending on the age of the individual.
Behavioral problems, like ODD and conduct disorder, occur in about 50% of children with ADHD, but are less common in adults with ADHD. Anxiety occurs in about 33% of children, depression in 17% and Tourette’s syndrome in about 1%.
Anxiety co-occurs with adult ADHD approximately 50% the time. And about 25% of adolescents and 50 % of adults are at risk for comorbid substance abuse issues with ADHD.
Treatment for Complex ADHD
Typically, ADHD symptoms will appear first. The typical approach to treating complex ADHD is to focus first on the ADHD, unless the co-morbid conditions are severe. In that case, the priority is reversed.
Treatment protocols may involve a combination of:
- Medications for both the ADHD and the co-occurring condition(s)
- Psychotherapy to help manage co-existing conditions
- ADHD and executive function coaching
- Accommodation in school or the workplace
- Lifestyle changes including nutrition, sleep, and exercise
The first step is to get a full assessment and diagnosis from a trained clinical professional.