Comorbidity of Adult Attention Deficit and Hyperactivity Disorder in Bipolar and Unipolar Patients

Harmanci, Hatice; Celikel, Feryal Cam; Etikán, Ílker

doi:10.5152/npa.2015.11328

Cited by 21 publications

(15 citation statements)

References 39 publications

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“…Externalizing disorders and cognitive impairment are also more common in individuals with major depressive disorder, bipolar disorder and schizophrenia (Raymond Lake, 2008; Harmancı et al ., 2016; Arican et al ., 2019). In line with previous findings (Maziade et al ., 2008; Ellersgaard et al ., 2018; Mackenzie et al ., 2019), our results suggest that attentional difficulties, oppositional behavior, and language/thought problems are elevated in youth at risk for mood and psychotic disorders even before the onset of these disorders and can be observed by an independent assessor without using a parent- or self-report.…”

Section: Discussionmentioning

confidence: 99%

Observed psychopathology in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia

et al. 2019

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BackgroundChildren of parents with mood and psychotic disorders are at elevated risk for a range of behavioral and emotional problems. However, as the usual reporter of psychopathology in children is the parent, reports of early problems in children of parents with mood and psychotic disorders may be biased by the parents' own experience of mental illness and their mental state.MethodsIndependent observers rated psychopathology using the Test Observation Form in 378 children and youth between the ages of 4 and 24 (mean = 11.01, s.d. = 4.40) who had a parent with major depressive disorder, bipolar disorder, schizophrenia, or no history of mood and psychotic disorders.ResultsObserved attentional problems were elevated in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia (effect sizes ranging between 0.31 and 0.56). Oppositional behavior and language/thought problems showed variable degrees of elevation (effect sizes 0.17 to 0.57) across the three high-risk groups, with the greatest difficulties observed in offspring of parents with bipolar disorder. Observed anxiety was increased in offspring of parents with major depressive disorder and bipolar disorder (effect sizes 0.19 and 0.25 respectively) but not in offspring of parents with schizophrenia.ConclusionsOur results suggest that externalizing problems and cognitive and language difficulties may represent a general manifestation of familial risk for mood and psychotic disorders, while anxiety may be a specific marker of liability for mood disorders. Observer assessment may improve early identification of risk and selection of youth who may benefit from targeted prevention.

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Section: Discussionmentioning

confidence: 99%

Observed psychopathology in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia

et al. 2019

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“…4,43 Suicidal behaviour in patients with a dual diagnosis of BD and ADHD In patients with BD, comorbid ADHD has been identified as a risk factor for suicidal behaviour. This increased risk has been found in adults overall, 3,8,44 as well as in young adults and adolescents. 12 However, one study did not find a significant association between ADHD and SA in adolescents with BD.…”

Section: Main Findingsmentioning

confidence: 72%

“…This prevalence lies well in the range of that reported in other studies (Table 5). 2,3,[29][30][31][32][33][34][35][36][37][38][39][40][41][42] Half of these other studies report more male participants, the other half reports more female participants. In our study, in keeping with the gender distribution in the entire LiSIE cohort, there were more women than men.…”

Section: Main Findingsmentioning

confidence: 99%

“…For individuals with BD, comorbid ADHD prevalence estimates range from 4% to 48%. 2 , 3 For individuals with ADHD, comorbid BD prevalence estimates range from 5% to 47%. 4 – 7 Co-occurrence of BD and ADHD is associated with unfavourable outcomes in terms of unemployment, lower socioeconomic status, unstable relationships, substance abuse, increased risk of hypomania and suicide attempts (SA).…”

Section: Introductionmentioning

confidence: 99%

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Suicidal and non-suicidal self-injurious behaviour in patients with bipolar disorder and comorbid attention deficit hyperactivity disorder after initiation of central stimulant treatment: a mirror-image study based on the LiSIE retrospective cohort

Öhlund

Ott

Lundqvist

et al. 2020

Therapeutic Advances in Psychopharmacology

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Background: Currently, our understanding regarding treatment of adult attention deficit hyperactivity disorder (ADHD) co-occurring with bipolar disorder (BD) remains limited. The aim of this study was to evaluate the impact of central stimulant (CS) treatment on suicidal and non-suicidal self-injurious behaviour in patients with a pre-existing diagnosis of BD or schizoaffective disorder (SZD). Specifically, we tested the hypothesis that CS treatment significantly decreased the number of suicide attempts and non-suicidal self-injury events. Methods: A mirror-image study in patients with a dual diagnosis of BD or SZD and ADHD, comparing suicide attempts and non-suicidal self-injury events within 6 months and 2 years before and after CS initiation. This study was part of a retrospective cohort study (LiSIE) into effects and side-effects of lithium for maintenance treatment of BD as compared with other mood stabilisers. Results: Of 1564 eligible patients, 206 patients met the inclusion criteria. Within the 6 months after CS initiation, suicide attempts and non-suicidal self-injury events decreased significantly, both in terms of numbers of patients having such events ( p = 0.013) and numbers of events experienced ( p = 0.004). These effects were preserved 2 years after CS initiation. Conclusions: CS treatment may reduce the risk of suicide attempts and non-suicidal self-injury events in patients with a dual diagnosis of BD or SZD and ADHD. Based on our findings, clinicians should not withhold CS treatment from patients with concomitant ADHD for fear of deterioration of the underlying BD. However, to minimise the risk of manic episodes concomitant mood stabiliser treatment and close monitoring remains warranted.

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“…The comorbidity concept is, however, supported by the fact that a majority of patients with comorbid BD and ADHD maintain both diagnoses after correction for overlapping symptoms (Milberger et al 1995). Moreover, BD with comorbid ADHD presents a worse course of illness than BD without ADHD, including earlier onset of bipolar disorder (Nierenberg et al 2005; Tamam et al 2008; Rydén et al 2009; Karaahmet et al 2013; Perroud et al 2014), as well as higher frequency of mood episodes (Nierenberg et al 2005; Tamam et al 2008; Rydén et al 2009; Perroud et al 2014; Torres et al 2015), suicide attempts (Nierenberg et al 2005; Torres et al 2015; Harmanci et al 2016), and interpersonal violence (Nierenberg et al 2005; Rydén et al 2009). This means that it is clinically important to identify BD patients with comorbid ADHD.…”

Section: Introductionmentioning

confidence: 99%

Neuropsychological profiles of adult bipolar disorder patients with and without comorbid attention-deficit hyperactivity disorder

Salarvan

Sparding

Clements

et al. 2019

Int J Bipolar Disord

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Background Comorbid attention-deficit/hyperactivity disorder (ADHD) is common in bipolar disorder and associated with worse outcomes. Cognitive testing might be a tool to identify this group. Here we compare the neuropsychological profiles of bipolar disorder patients with (BD + cADHD) and without (BD − cADHD) childhood attention-deficit hyperactivity disorder. Methods Adult patients with BD − cADHD (n = 66), BD + cADHD (n = 32), and healthy controls (n = 112) were tested using a comprehensive battery of neuropsychological tests. Patients underwent rigorous diagnostic assessments for bipolar disorder and ADHD, as well as a parental interview to establish childhood ADHD. Results The neuropsychological profiles of the groups were similar, except that the BD + cADHD group performed significantly worse on working memory. Working memory did not differ between those in the BD + cADHD group who only had a history of childhood ADHD and those that still met criteria for ADHD in adulthood. Conclusions Cognitive testing had limited power to differentiate between bipolar disorder adults with and without childhood ADHD. The BD + cADHD subgroup cannot explain the significant cognitive heterogeneity seen in bipolar disorder patients. Electronic supplementary material The online version of this article (10.1186/s40345-019-0149-9) contains supplementary material, which is available to authorized users.

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Comorbidity of Adult Attention Deficit and Hyperactivity Disorder in Bipolar and Unipolar Patients

Cited by 21 publications

References 39 publications

Observed psychopathology in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia

Observed psychopathology in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia

Suicidal and non-suicidal self-injurious behaviour in patients with bipolar disorder and comorbid attention deficit hyperactivity disorder after initiation of central stimulant treatment: a mirror-image study based on the LiSIE retrospective cohort

Neuropsychological profiles of adult bipolar disorder patients with and without comorbid attention-deficit hyperactivity disorder

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