Retrospective analysis of potential sex differences in naturally emerging psychiatric comorbidities over time in Turkish children and adolescents with attention deficit/hyperactivity disorder

Abstract Background Attention Deficit Hyperactivity Disorder (ADHD) comorbidity patterns vary by sex and age, necessitating understanding for effective diagnosis and intervention. The aim was to assess the prevalence, timing, and distribution of comorbid psychiatric disorders in a Turkish sample, fo...

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Main Authors: Sabide Duygu Uygun, Zeynep Toprak-Kosku, Rahime Duygu Temeltürk, Merve Çıkılı-Uytun, Esra Yürümez, Didem Behice Öztop, Tuğba Menteşe-Babayiğit, Gökçe Yağmur Efendi, Birim Günay Kılıç
Format: Article
Language:English
Published: SpringerOpen 2025-06-01
Series:Middle East Current Psychiatry
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Online Access:https://doi.org/10.1186/s43045-025-00543-9
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author Sabide Duygu Uygun
Zeynep Toprak-Kosku
Rahime Duygu Temeltürk
Merve Çıkılı-Uytun
Esra Yürümez
Didem Behice Öztop
Tuğba Menteşe-Babayiğit
Gökçe Yağmur Efendi
Birim Günay Kılıç
author_facet Sabide Duygu Uygun
Zeynep Toprak-Kosku
Rahime Duygu Temeltürk
Merve Çıkılı-Uytun
Esra Yürümez
Didem Behice Öztop
Tuğba Menteşe-Babayiğit
Gökçe Yağmur Efendi
Birim Günay Kılıç
author_sort Sabide Duygu Uygun
collection DOAJ
description Abstract Background Attention Deficit Hyperactivity Disorder (ADHD) comorbidity patterns vary by sex and age, necessitating understanding for effective diagnosis and intervention. The aim was to assess the prevalence, timing, and distribution of comorbid psychiatric disorders in a Turkish sample, focusing on potential sex differences. Methods A retrospective study included 322 children with ADHD (aged 6 to 18 years). Data, including Conners’ Parent/Teacher Rating Scales (CP/TRS), were collected from university-based clinical records. Results Females with ADHD had a higher rate of psychiatric comorbidity compared to males (83.5% vs. 62.7%, p < .001). Neurodevelopmental disorders were more prevalent in females (p < .001). All CTRS indexes (ADHD, restless/impulsive, emotional lability, and total), as well as oppositional and hyperactive/impulsive subscale scores, showed mild negative correlations with the timing of the first comorbidity other than neurodevelopmental disorders. Logistic regression identified age and specific learning disorders (SLD) as predictors of comorbidity onset (p = .004 and p = .001, respectively). Atomoxetine was preferred more often as a first-line treatment in females, while psychostimulants were used at higher doses in males (p = .035 and p = .050, respectively). Conclusions More attention is needed for females with ADHD. Oppositionality, impulsivity, emotional lability, ADHD severity, age, and SLD appear to be important for the onset of internalizing and externalizing comorbidities.
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spelling doaj-art-155b640c2e3544f3a3a0f26eb5ed6c712025-08-20T02:37:57ZengSpringerOpenMiddle East Current Psychiatry2090-54162025-06-0132111310.1186/s43045-025-00543-9Retrospective analysis of potential sex differences in naturally emerging psychiatric comorbidities over time in Turkish children and adolescents with attention deficit/hyperactivity disorderSabide Duygu Uygun0Zeynep Toprak-Kosku1Rahime Duygu Temeltürk2Merve Çıkılı-Uytun3Esra Yürümez4Didem Behice Öztop5Tuğba Menteşe-Babayiğit6Gökçe Yağmur Efendi7Birim Günay Kılıç8Department of Child and Adolescent Psychiatry, Ankara University School of MedicineDepartment of Child and Adolescent Psychiatry, Ankara Training and Research HospitalDepartment of Child and Adolescent Psychiatry, Ankara University School of MedicineDepartment of Child and Adolescent Psychiatry, Ankara University School of MedicineDepartment of Child and Adolescent Psychiatry, Ankara University School of MedicineDepartment of Child and Adolescent Psychiatry, Ankara University School of MedicineDepartment of Child and Adolescent Psychiatry, Aksaray Training and Research HospitalDepartment of Child and Adolescent Psychiatry, Kocaeli University School of MedicineDepartment of Child and Adolescent Psychiatry, Retired From Ankara University School of MedicineAbstract Background Attention Deficit Hyperactivity Disorder (ADHD) comorbidity patterns vary by sex and age, necessitating understanding for effective diagnosis and intervention. The aim was to assess the prevalence, timing, and distribution of comorbid psychiatric disorders in a Turkish sample, focusing on potential sex differences. Methods A retrospective study included 322 children with ADHD (aged 6 to 18 years). Data, including Conners’ Parent/Teacher Rating Scales (CP/TRS), were collected from university-based clinical records. Results Females with ADHD had a higher rate of psychiatric comorbidity compared to males (83.5% vs. 62.7%, p < .001). Neurodevelopmental disorders were more prevalent in females (p < .001). All CTRS indexes (ADHD, restless/impulsive, emotional lability, and total), as well as oppositional and hyperactive/impulsive subscale scores, showed mild negative correlations with the timing of the first comorbidity other than neurodevelopmental disorders. Logistic regression identified age and specific learning disorders (SLD) as predictors of comorbidity onset (p = .004 and p = .001, respectively). Atomoxetine was preferred more often as a first-line treatment in females, while psychostimulants were used at higher doses in males (p = .035 and p = .050, respectively). Conclusions More attention is needed for females with ADHD. Oppositionality, impulsivity, emotional lability, ADHD severity, age, and SLD appear to be important for the onset of internalizing and externalizing comorbidities.https://doi.org/10.1186/s43045-025-00543-9Attention deficit hyperactivity disorderComorbiditySex characteristicsChild and adolescent psychiatryNeurodevelopment condition
spellingShingle Sabide Duygu Uygun
Zeynep Toprak-Kosku
Rahime Duygu Temeltürk
Merve Çıkılı-Uytun
Esra Yürümez
Didem Behice Öztop
Tuğba Menteşe-Babayiğit
Gökçe Yağmur Efendi
Birim Günay Kılıç
Retrospective analysis of potential sex differences in naturally emerging psychiatric comorbidities over time in Turkish children and adolescents with attention deficit/hyperactivity disorder
Middle East Current Psychiatry
Attention deficit hyperactivity disorder
Comorbidity
Sex characteristics
Child and adolescent psychiatry
Neurodevelopment condition
title Retrospective analysis of potential sex differences in naturally emerging psychiatric comorbidities over time in Turkish children and adolescents with attention deficit/hyperactivity disorder
title_full Retrospective analysis of potential sex differences in naturally emerging psychiatric comorbidities over time in Turkish children and adolescents with attention deficit/hyperactivity disorder
title_fullStr Retrospective analysis of potential sex differences in naturally emerging psychiatric comorbidities over time in Turkish children and adolescents with attention deficit/hyperactivity disorder
title_full_unstemmed Retrospective analysis of potential sex differences in naturally emerging psychiatric comorbidities over time in Turkish children and adolescents with attention deficit/hyperactivity disorder
title_short Retrospective analysis of potential sex differences in naturally emerging psychiatric comorbidities over time in Turkish children and adolescents with attention deficit/hyperactivity disorder
title_sort retrospective analysis of potential sex differences in naturally emerging psychiatric comorbidities over time in turkish children and adolescents with attention deficit hyperactivity disorder
topic Attention deficit hyperactivity disorder
Comorbidity
Sex characteristics
Child and adolescent psychiatry
Neurodevelopment condition
url https://doi.org/10.1186/s43045-025-00543-9
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