Comorbidity between attention deficit hyperactivity disorder (ADHD) and bipolar disorder in a specialized mood disorders outpatient clinic

Nader Perroud; Paolo Cordera; Julien Zimmermann; Giorgio Michalopoulos; Victor Bancila; Paco Prada; Alexandre Dayer; Jean-Michel Aubry

doi:10.1016/j.jad.2014.06.053

Comorbidity between attention deficit hyperactivity disorder (ADHD) and bipolar disorder in a specialized mood disorders outpatient clinic

J Affect Disord. 2014 Oct:168:161-6. doi: 10.1016/j.jad.2014.06.053. Epub 2014 Jul 9.

Authors

Nader Perroud¹, Paolo Cordera², Julien Zimmermann², Giorgio Michalopoulos², Victor Bancila², Paco Prada², Alexandre Dayer³, Jean-Michel Aubry³

Affiliations

¹ Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva, Switzerland; Department of Psychiatry, University of Geneva, Switzerland. Electronic address: nader.perroud@hcuge.ch.
² Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva, Switzerland.
³ Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva, Switzerland; Department of Psychiatry, University of Geneva, Switzerland.

PMID: 25051093
DOI: 10.1016/j.jad.2014.06.053

Abstract

Background: Comorbidity between ADHD and Bipolar Disorder (BD) is associated with greater severity of BD. The current study aims at investigating, in a specialized mood disorders clinic, the percentage of comorbid ADHD-BD subjects and assessing the impact of ADHD on the severity of BD.

Methods: Out of 539 mood disorders subjects, the medical records of 138 BD subjects were scrutinized in terms of their clinical and demographic characteristics, and their scores at the Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist were logged. Those positively scoring at the ASRS-v1.1 underwent clinical assessment by a senior psychiatrist specialized in ADHD. Comorbid ADHD-BD subjects were then compared with BD sufferers without ADHD.

Results: Sixty-three (45.65%) of the participants were screened positive at the ASRS-v1.1. 49 were clinically assessed for the presence of ADHD. Only 27 (55%) received a diagnosis of ADHD. Comorbid ADHD-BD subjects were found to be younger at the onset of BD, showed higher numbers of depressive episodes, more anxiety and substance use disorders, more borderline personality traits and greater cyclothymic temperament. Comorbid BD-ADHD subjects reported more childhood emotional abuse.

Limitations: Some subjects were unreachable and thus not clinically assessed for ADHD.

Conclusions: More than 20% of BD subjects were suffering from ADHD. The comorbidity of the two disorders was associated with worse outcomes, possibly resulting from stressful early-life events. More than 40% of the subjects who scored positively at the ASRS-v1.1 did not suffer from ADHD, which suggests that this scale should be used with caution in BD subjects.

Keywords: ADHD; Bipolar disorder; Psychiatry.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Ambulatory Care Facilities
Anxiety / epidemiology
Anxiety / psychology
Attention Deficit Disorder with Hyperactivity / epidemiology*
Attention Deficit Disorder with Hyperactivity / psychology*
Bipolar Disorder / epidemiology*
Bipolar Disorder / psychology*
Borderline Personality Disorder / epidemiology
Borderline Personality Disorder / psychology
Comorbidity
Cyclothymic Disorder / epidemiology
Cyclothymic Disorder / psychology
Depression / epidemiology
Depression / psychology
Female
Humans
Life Change Events*
Male
Middle Aged
Self Report
Switzerland / epidemiology
Temperament