Premorbid prevalence of ADHD and development of secondary ADHD after closed head injury

Joan P. Gerring, Kathleen D. Brady, Anita Chen, Roma Vasa, Marco Grados, Karen J. Bandeen-Roche, R. Nick Bryan, Martha Bridge Denckla

Research output: Contribution to journalArticlepeer-review

161 Scopus citations


Objective: To determine premorbid prevalence of attention-deficit hyperactivity disorder (ADHD) in children with moderate and severe closed head injury (CHI), to determine incidence of ADHD 1 year after injury, and to characterize children who develop ADHD by demographic, neuropsychiatric, and outcome variables. Method: Ninety-nine children who had severe and moderate CHI were followed up for 1 year. Premorbid and 1-year postinjury psychiatric status were ascertained by parent and child structured interviews and questionnaires measuring affective lability, aggression, apathy, and social judgment. Results: Premorbid prevalence of ADHD was 0.20, significantly higher than in a reference population (0.045). Fifteen of the remaining 80 children (0.19) developed full ADHD criteria (except for age of onset) by the end of the first year. Children who developed secondary ADHD (S-ADHD) had significantly greater premorbid psychosocial adversity, posttraumatic affective lability and aggression, posttraumatic psychiatric comorbidity, and overall disability than children who did not develop S-ADHD. Conclusions: There is an excess prevalence of premorbid ADHD among children who present with moderate and severe CHI. Children with high psychosocial adversity are more likely to develop S-ADHD after CHI. S-ADHD has criteria in common with personality change due to CHI, a deficit in behavioral inhibition being the major overlapping feature.

Original languageEnglish (US)
Pages (from-to)647-654
Number of pages8
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number6
StatePublished - Jun 1998


  • Attention-deficit hyperactivity disorder
  • Closed head injury
  • Personality change due to closed head injury

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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