Psychiatric Comorbidities in 7-12 Year Old Children Diagnosed With ADHD in South Africa: A Record Review

Background ADHD is a prevalent neurodevelopmental disorder frequently accompanied by psychiatric comorbidities. While international evidence is well-established, data from South Africa — particularly in younger children — remain limited. Aim To describe psychiatric comorbidities and associated factors in children aged 7–12 years with primary ADHD at the Child, Adolescent, and Family Unit (CAFU), Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Methods A retrospective cross-sectional record review of children aged 7–12 years with primary ADHD at CAFU between January 2020 and December 2022. Data were analysed using SPSS version 26. Results Of 573 records screened, 108 were included. The combined subtype was most prevalent (72.2%). Almost all children (95.5%) had at least one comorbidity. The most frequent were generalised anxiety disorder (52.8%), intellectual disability (38.9%), and oppositional defiant disorder (29.6%). Females were more likely to present with oppositional defiant disorder ( p = .007) and males with autism spectrum disorder ( p = .032). High rates of domestic violence (29.6%), parental substance abuse (33.3%), and parental psychiatric history (30.6%) were documented. Conclusion Psychiatric comorbidities are highly prevalent in South African children with ADHD, exceeding international estimates, and reflect the broader psychosocial context of the setting. Comprehensive, multidisciplinary, and trauma-informed assessments are essential.