Tamam Lut, Tuğlu Cengiz, Karatas Gonca, Ozcan Sevilay
Department of Psychiatry, Faculty of Medicine, Cukurova University, Adana, Turkey.
Psychiatry Clin Neurosci. 2006 Aug;60(4):480-5. doi: 10.1111/j.1440-1819.2006.01535.x.
Attention-deficit hyperactivity disorder (ADHD), a syndrome that typically first appears in early childhood, can occur in individuals of all ages. Prospective studies have demonstrated that at least half of children diagnosed as having ADHD continue to suffer the symptoms of this disorder in their adult life with significant impacts on their social status, achievement level and sense of well-being. The purpose of this preliminary study was to determine the rate of ADHD in patients with bipolar disorder (BD) and to examine the effects of comorbid ADHD on several clinical and sociodemographic variables of bipolar patients. Forty-four BD-I patients followed up in psychiatric outpatient clinics in two university hospitals, were assessed for the presence of adult ADHD according to DSM-IV. All patients also completed the Wender Utah Rating Scale for objective evaluation of ADHD. Of 44 patients with BD-I, only seven (15.9%) fulfilled criteria for a diagnosis of adult ADHD. Bipolar disorder-I patients with comorbid ADHD were more likely to be female, and have more affective episodes (especially depressive episodes) than bipolar patients without comorbid ADHD. Age at onset of affective illness was not significantly different between the two groups. In line with results of several previous reports, the present study also showed higher prevalence of ADHD in patients with BD-I than in normal population. A higher number of affective episode in patients with comorbid ADHD may suggest a more severe clinical course of BD in these patients. A larger group of samples is required to clarify the exact association and interaction between these two clinical entities.
注意缺陷多动障碍（ADHD）是一种通常在幼儿期首次出现的综合征，可发生于各年龄段的个体。前瞻性研究表明，至少一半被诊断患有ADHD的儿童在成年后仍会遭受该疾病的症状困扰，这对他们的社会地位、成就水平和幸福感产生重大影响。这项初步研究的目的是确定双相情感障碍（BD）患者中ADHD的发生率，并研究共病ADHD对双相情感障碍患者的一些临床和社会人口统计学变量的影响。在两家大学医院的精神科门诊对44例BD-I患者进行随访，根据《精神疾病诊断与统计手册》第四版（DSM-IV）评估成人ADHD的存在情况。所有患者还完成了温德犹他评定量表，以客观评估ADHD。在44例BD-I患者中，只有7例（15.9%）符合成人ADHD的诊断标准。与无共病ADHD的双相情感障碍患者相比，共病ADHD的双相情感障碍-I患者更可能为女性，且有更多的情感发作（尤其是抑郁发作）。两组情感疾病的发病年龄无显著差异。与之前几份报告的结果一致，本研究还显示BD-I患者中ADHD的患病率高于正常人群。共病ADHD的患者情感发作次数较多，这可能表明这些患者的双相情感障碍临床病程更严重。需要更大规模的样本组来阐明这两种临床疾病的确切关联和相互作用。
