Abstract
Objective:
To investigate the frequency of severe mood dysregulation (SMD) in an attention deficit hyperactivity dis-order (ADHD) sample and to assess uıhether there was a difference regarding anxiety levels and cognitive flexibility in children uith ADHD + a comorbid disorder and in children uith ADHD + SMD.
Method:
The diagnoses of ADHD, SMD and otherpsychiatric conditions uere assessed by Schedule for Affective Disorders and Schizophrenia for School Aged Children- Present and Lifetime Version and its SMD module in 95 subjects uith ADHD (80% (n=76) boys and 20% (n=19) girls, mean age 10.61±2.31 years). Anxiety symptoms uere measured by the State - Trait Anxiety Inventory for Chldren. WISC-R, Wisconsin Card Sorting Test (WCST) and Trail Making Test (TMT)-A and B uere used to measure neuropsychological performance of the children.
Results:
10.5% of children uith ADHD were diagnosed as SMD. On the WCST, the groups had a statistically significant difference for the number of categories completed, total error score, and total correct response score. Post hocpairuise comparisons showed thatpatients uith ADHD+SMD signifi-cantly made more errors, completed less number of categories and had less total correct response scores than those uith comorbid oppositional defiant disorder/ conduct disorder (ODD/CD). ADHD +SMD group (mean±sd= 44.4±7.3) had significantly higher trait anxiety compared to the ADHD+anxiety disorders group (mean±sd= 36.2±6.6) (p=0,01). There uere no differences in terms of TMTpart A and B scores and WISC-R subscores betueen groups.
Discussion:
SMD might be a different clinical disorder than ADHD+ODD/CD in terms of cognitive flexibility but remains close to disruptive behavior disorders spectrum.
Keywords: SMD, ADHD, cognitive flexibility, trait anxiety
