Psychiatric Features and Parenting Stress Profiles of Subtypes of Attention-Deficit/Hyperactivity Disorder: Results from a Clinically Referred Taiwanese Sample

OBJECTIVE: This study attempts to evaluate whether there are attention deficit/ hyperactivity disorder (ADHD) subtype differences regarding psychiatric features, comorbidity pattern and parenting stress profiles in an Asian population. METHODS: A total of 182 ADHD children and their primary caretakers recruited from a university-affiliated hospital were surveyed. Subjects were two groups of preadolescent (6 to 12 years old) ADHD children: children with ADHD-inattentive subtype (n=58) and ADHD-combined subtype (n=124). Various information was collected and compared, including the child's characteristics (current age, gender, number of family members, age at ADHD diagnosis, duration of pharmaceutical intervention, psychiatric comorbidities, and intelligence quotient); the primary caretaker's characteristics, and profiles obtained with the Parenting Stress Index (PSI). RESULTS: Group comparison showed that these two subtypes were statistically distinguishable from each other in total scores on the PSI, four subscale scores on the PSI, the child's age at diagnosis, and comorbidity profiles (all p<.05). Parents of children of the combined subtype experienced higher parenting stress and felt their children displayed qualities that made it difficult for them to fulfill their parenting roles. School failure (p=.001) and anxiety disorders (p=.022) were significantly more prevalent in the inattentive subtype children, while oppositional defiant disorder was significantly more present in the combined subtype children (p=.000). CONCLUSIONS: Our findings supported the cross-cultural equivalence of the nosological distinction in ADHD subtypes. The need for specific clinical intervention according to the subtype difference was stressed.