Patients with mood disorders at increased risk of being diagnosed with lifelong attention deficit hyperactivity disorder

A systematic review and meta-analysis showed that individuals with bipolar disorder (BD) and major depressive disorder (MDD) were at increased risk of comorbid attention deficit hyperactivity disorder (ADHD). These results were published in Acta Psychiatrica Scandinavica.

Researchers at Dalhousie University in Canada searched publication databases for articles on ADHD, attention deficit disorder (ADD), BD and affective psychosis through September 2020.

A total of 127 articles with 33,986 patients with ADHD and BD (n = 17,089) or MDD (n = 16,897) were included in this analysis.

In 73% (95% CI, 66% -79%) of the BD patients, comorbid ADHD was diagnosed in childhood, in adolescence 43% (95% CI, 35% -50%) and in adolescence 17% (95% CI) . 14% -20%) in adulthood (range I2, 90.00% -93.20%).

Stratified by age of ADHD diagnosis, version of Diagnostic and Statistics Manual (DSM) (b, -1.10; 95% CI, -2.02 to -0.18; P = 0.022), age (b, -0 , 49; 95% CI, -0.76) to -0.21; P = 0.001) and gender (b, 0.05; 95% CI, 0.01-0.09; P = 0.021) were significant predictors of ADHD in childhood and adolescents, ADHD-related geographic location (b, -0.97; 95% CI, -1.69 to -0.25; P = 0.01).

In 28% (95% CI, 19% -39%) of the patients with MDD, comorbid ADHD was diagnosed in childhood, in adolescence 17% (95%, CI, 12% -24%) and in adolescence 7% (95% CI ) 4% -11%) in adulthood (range I2, 91.10% -96.50%).

Stratified by age at diagnosis of ADHD, age (b, -0.06; 95% CI, -0.12 to -0.003; P = 0.04) was a significant predictor of ADHD in adults.

When comparing studies, ADHD was more common in patients with BD (risk ratio) [RR]1.72; 95% CI, 1.20-2.47; P = 0.003; I2, 82.80%) compared to MDD. Among the 15 studies that included data on healthy controls, patients with mood disorders had an increased risk of ADHD (RR 3.42; 95% CI 2.81-4.16; P <0.001; I2 59.70%).

This study was limited by the high heterogeneity observed in the underlying studies.

These results indicated that people with mood disorders were at increased risk of comorbid ADHD, suggesting that patients with BD or MDD may need additional screening for ADHD to ensure adequate and effective treatment.

Disclosure: An author has declared his affiliation with the industry. For a full list of details, see the original article.


Sandstrom A, Perroud N, Alda M, Uher R, Pavlova B. Prevalence of attention deficit / hyperactivity disorder in people with mood disorders: A systematic review and meta-analysis. Acta Psychiatr Scand. Published online February 2, 2021. doi: 10.1111 / acps.13283

This article originally appeared on Psychiatry Advisor

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