Comorbid psychiatric disorders in a clinical sample of adults with ADHD, and associations with education, work and social characteristics: a cross-sectional study

Abstract

ObjectivesAdults with attention-deficit hyperactive disorder (ADHD) report high rates of comorbid disorders, educational and occupational failure, and family instability. The aim of this study was to examine the prevalence of comorbid psychiatric disorders in a clinical population of adults with ADHD and to examine associations between educational level, work participation, social characteristics and the rates of psychiatric comorbidity.MethodsOut of 796 patients diagnosed with ADHD in a specialised outpatient clinic in Oslo, Norway, 548 (68%) agreed to participate in this cross-sectional study: 277 women and 271 men. ADHD was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Comorbid disorders were diagnosed using the Mini-International Neuropsychiatric Interview.ResultsIn this clinical sample, 53.5% had at least one current comorbid psychiatric disorder. The most prevalent disorders were major depression, substance use disorders and social phobia. Women had more eating disorders than men, whereas men had more alcohol and substance use disorders. Education above high school level (>12 years) and work participation were associated with lower rates of comorbid disorders (adjusted ORs 0.52 and 0.63, respectively). Gender, age, marital status, living with children or living in a city were not associated with comorbidity.ConclusionsAdult ADHD is associated with high rates of comorbid psychiatric disorders, irrespective of gender and age. It appears that higher education and work participation are related to lower probability of comorbidity.

Shared genetic background between children and adults with attention deficit/hyperactivity disorder

“…The presentation of ADHD symptoms changes from childhood to adulthood, with lower levels of hyperactivity in adulthood but a high risk for ongoing attention problems, disorganization, and emotional dysregulation [ 13 , 14 ]. As in the general population, the pattern of psychiatric and somatic comorbid conditions in ADHD also changes substantially over time, with learning disabilities, oppositional defiant disorder, and conduct disorder being more prevalent in children, and substance use disorders, social phobia, insomnia, obesity, and mood disorders becoming more pronounced in adulthood [ 1 , 15 – 18 ]. In addition, persistent ADHD in adults is, compared with the general population (and to cases with remitting ADHD), associated with higher risk for a wide range of functional and social impairments, including unemployment, accidents, and criminal behavior [ 7 , 19 – 23 ].…”

Attention Deficit Hyperactivity Disorder in Prisoners: Increased Substance Use Disorder Severity and Psychiatric Comorbidity

“…Prevalence of anxiety, depression, bipolar and personality disorders, schizophrenia, and substance use disorder (SUD) is 4–9 times higher in ADHD populations than in the general adult population [11]. In clinical samples, around 50% of patients with ADHD have at least one current comorbid disorder [12], while around 75% of patients in treatment for SUDs who have ADHD have at least one current comorbid disorder [13].…”

The Importance of Belonging to a Context: A Nurse-Led Lifestyle Intervention for Adult Persons with ADHD

“…According to the WHO, two out of three deaths are related to lifestyle-related diseases (The Lancet, 2018). Adult persons with attention deficit hyperactivity disorder (ADHD) have an increased risk of physical and mental comorbidities mainly due to an unhealthy lifestyle (Anker et al, 2018;Instanes et al, 2018;Nutt et al, 2007;Stickley et al, 2017). Persons with ADHD are overrepresented when it comes to mental illness.…”