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Clinical and diagnostic implications of lifetime attention-deficit/hyperactivity disorder comorbidity in adults with bipolar disorder: data from the first 1000 STEP-BD participants.
Biol Psychiatry. 2005 Jun 01; 57(11):1467-73.BP

Abstract

BACKGROUND

Systematic studies of children and adolescents with a diagnosis of bipolar disorder show that rates of attention-deficit/hyperactivity disorder (ADHD) range from 60% to 90%, but the prevalence and implications of ADHD in adults with bipolar disorder are less clear.

METHODS

The first consecutive 1000 adults with bipolar disorder enrolled in the National Institute of Mental Health's Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were assessed for lifetime ADHD. The retrospective course of bipolar disorder, current mood state, and prevalence of other comorbid psychiatric diagnoses were compared for the groups with and without lifetime comorbid ADHD.

RESULTS

The overall lifetime prevalence of comorbid ADHD in this large cohort of bipolar patients was 9.5% (95% confidence interval 7.6%-11.4%); 14.7% of male patients and 5.8% of female patients with bipolar disorder had lifetime ADHD. Patients with bipolar disorder and ADHD had the onset of their mood disorder approximately 5 years earlier. After adjusting for age of onset, those with ADHD comorbidity had shorter periods of wellness and were more frequently depressed. We found that patients with bipolar disorder comorbid with ADHD had a greater number of other comorbid psychiatric diagnoses compared with those without comorbid ADHD, with substantially higher rates of several anxiety disorders and alcohol and substance abuse and dependence.

CONCLUSIONS

Lifetime ADHD is a frequent comorbid condition in adults with bipolar disorder, associated with a worse course of bipolar disorder and greater burden of other psychiatric comorbid conditions. Studies are needed that focus on the efficacy and safety of treating ADHD comorbid with bipolar disorder.

Authors+Show Affiliations

Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Depression and Clinical Research Program ACC 812, Boston, Massachusetts 02114, USA. anierenberg@partners.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15950022

Citation

Nierenberg, Andrew A., et al. "Clinical and Diagnostic Implications of Lifetime Attention-deficit/hyperactivity Disorder Comorbidity in Adults With Bipolar Disorder: Data From the First 1000 STEP-BD Participants." Biological Psychiatry, vol. 57, no. 11, 2005, pp. 1467-73.
Nierenberg AA, Miyahara S, Spencer T, et al. Clinical and diagnostic implications of lifetime attention-deficit/hyperactivity disorder comorbidity in adults with bipolar disorder: data from the first 1000 STEP-BD participants. Biol Psychiatry. 2005;57(11):1467-73.
Nierenberg, A. A., Miyahara, S., Spencer, T., Wisniewski, S. R., Otto, M. W., Simon, N., Pollack, M. H., Ostacher, M. J., Yan, L., Siegel, R., & Sachs, G. S. (2005). Clinical and diagnostic implications of lifetime attention-deficit/hyperactivity disorder comorbidity in adults with bipolar disorder: data from the first 1000 STEP-BD participants. Biological Psychiatry, 57(11), 1467-73.
Nierenberg AA, et al. Clinical and Diagnostic Implications of Lifetime Attention-deficit/hyperactivity Disorder Comorbidity in Adults With Bipolar Disorder: Data From the First 1000 STEP-BD Participants. Biol Psychiatry. 2005 Jun 1;57(11):1467-73. PubMed PMID: 15950022.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and diagnostic implications of lifetime attention-deficit/hyperactivity disorder comorbidity in adults with bipolar disorder: data from the first 1000 STEP-BD participants. AU - Nierenberg,Andrew A, AU - Miyahara,Sachiko, AU - Spencer,Tom, AU - Wisniewski,Stephen R, AU - Otto,Michael W, AU - Simon,Naomi, AU - Pollack,Mark H, AU - Ostacher,Michael J, AU - Yan,Leslie, AU - Siegel,Rebecca, AU - Sachs,Gary S, AU - ,, PY - 2003/08/20/received PY - 2004/03/09/revised PY - 2005/01/21/accepted PY - 2005/6/14/pubmed PY - 2005/7/30/medline PY - 2005/6/14/entrez SP - 1467 EP - 73 JF - Biological psychiatry JO - Biol Psychiatry VL - 57 IS - 11 N2 - BACKGROUND: Systematic studies of children and adolescents with a diagnosis of bipolar disorder show that rates of attention-deficit/hyperactivity disorder (ADHD) range from 60% to 90%, but the prevalence and implications of ADHD in adults with bipolar disorder are less clear. METHODS: The first consecutive 1000 adults with bipolar disorder enrolled in the National Institute of Mental Health's Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were assessed for lifetime ADHD. The retrospective course of bipolar disorder, current mood state, and prevalence of other comorbid psychiatric diagnoses were compared for the groups with and without lifetime comorbid ADHD. RESULTS: The overall lifetime prevalence of comorbid ADHD in this large cohort of bipolar patients was 9.5% (95% confidence interval 7.6%-11.4%); 14.7% of male patients and 5.8% of female patients with bipolar disorder had lifetime ADHD. Patients with bipolar disorder and ADHD had the onset of their mood disorder approximately 5 years earlier. After adjusting for age of onset, those with ADHD comorbidity had shorter periods of wellness and were more frequently depressed. We found that patients with bipolar disorder comorbid with ADHD had a greater number of other comorbid psychiatric diagnoses compared with those without comorbid ADHD, with substantially higher rates of several anxiety disorders and alcohol and substance abuse and dependence. CONCLUSIONS: Lifetime ADHD is a frequent comorbid condition in adults with bipolar disorder, associated with a worse course of bipolar disorder and greater burden of other psychiatric comorbid conditions. Studies are needed that focus on the efficacy and safety of treating ADHD comorbid with bipolar disorder. SN - 0006-3223 UR - https://www.unboundmedicine.com/medline/citation/15950022/Clinical_and_diagnostic_implications_of_lifetime_attention_deficit/hyperactivity_disorder_comorbidity_in_adults_with_bipolar_disorder:_data_from_the_first_1000_STEP_BD_participants_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0006-3223(05)00113-7 DB - PRIME DP - Unbound Medicine ER -