Assessment of plasma cortisol level in prepubertal boy with attention deficit hyperactivity disorder and comorbid oppositional defiant disorder

Abstract

Objective: The aim of this study is assessing the plasma cortisol level in children with attention deficit hyperactivity disorder (ADHD) and ADHD with comorbid oppositional defiant disorder (ODD) in comparison with a healthy control group. Method: The study included children between the ages of 6 and 11 with ADHD and ADHD+ODD diagnosis on the basis of DSM-IV diagnosis criteria, who were seeking medical treatment for the first time at the child psychiatry outpatient unit. The ADHD group included 21 boys, the ADHD+ODD group included 26 boys, and control group comprising healthy volunteers included 27 boys. Scanning and Evaluation Scale based on DSM-IV for Attention Deficit and Disruptive Behavioral Disorders and the Child Behaviour Check Lists for Children and Adolescents (CBCL) between the ages of 4-18 were completed by the mothers. Conners Teacher Rating Scale short form were completed by the teachers. Blood samples were taken at 08:15 a.m. and 09:00 a.m. in two stages to evaluate the cortisol levels. Results: The average cortisol levels were significantly lower in ADHD+ODD group as compared to ADHD only and control groups. The cortisol levels were negatively correlated with the ratings on the aggressive behavior, delinquency, externalizing problems subscales of the CBCL. Conclusion: The plasma cortisol levels in disruptive behavior disorders might be biological maker for aggression.