ASSOCIATION OF FAMILY CONFLICT AND FAMILY COHESION WITH DEVELOPMENT OF COMORBID DISRUPTIVE BEHAVIOR DISORDER IN CHILDREN WITH ATTENTION DEFICIT HYPERACTIVE DISORDER – A CASE CONTROL STUDY

Abstract

Objectives: Attention Decit Hyperactivity Disorder (ADHD) is one of the most common neuro-developmental disorders in children. Most common comorbidity is Disruptive behavior disorder (DBD) consisting of Oppositional Deant Disorder (ODD) and Conduct Disorder (CD). Family and social environmental factors may contribute to develop DBD in children with genetic vulnerability. This study was done to nd out the association of family conict and family cohesion with development of comorbid DBD in children with ADHD. Methods: This case-control, cross sectional study was done in a child Guidance clinic of R.G Kar Medical College, Kolkata. Total study population(N=154) comprises of children diagnosed as ADHD with co morbid DBD (N=53), ADHD only (N=39) and Normal children (N=62). Children fullling the inclusion and exclusion criteria were screened using Child symptom inventory (for10-12 years age) and Devereux Scales of Mental Disorders (for 13-15 years age) and then diagnosed according to DSM IV TR. Control population was collected from schools after screening out for having any psychiatric disorder (N =62). The consenting parents of the cases and control were assessed using Family Environmental scale (F.E.S). Results: Signicant differences were found in family conict and family cohesion among these 3 groups. Families of children with ADHD with co morbid DBD (ODD or CD) had signicantly higher family conict and lower cohesion than families of children with ADHD alone and control children. Conclusion: High family conict and low cohesion are associated with development of DBD in children with ADHD.