Berkol Tonguç Demir, Yargiç İlhan, Özyildirim İlker, Yazici Olcay
Bakırköy Sadi Konuk Hospital, Department of Psychiatry, İstanbul, Turkey.
İstanbul University Faculty of Medicine, Department of Psychiatry, İstanbul, Turkey.
Noro Psikiyatr Ars. 2014 Jun;51(2):97-102. doi: 10.4274/npa.y6376. Epub 2014 Jun 1.
The aims of this study were to determine the frequency of adult attention deficit and hyperactivity disorder (ADHD) comorbidity in bipolar patients and to investigate the influence of this comorbidity on the clinical characteristics of bipolar disorder (BD).
A total of 135 patients with BD type I and II and BD not otherwise specified were included in this study. First, the Adult ADD/ADHD DSM-IV-Based Diagnostic Screening and Rating Scale (ADHD scale) was administered to all patients, and all of the patients were also interviewed for the diagnosis. Patients who were diagnosed as having ADHD comorbidity (n=23) on the basis of DSM-IV and those who were not diagnosed to have ADHD comorbidity (n=32) were compared in terms of sociodemographic and clinical correlates.
Twenty-three of 135 patients (17%) were found to have ADHD comorbidity. In the ADHD comorbidity group, the level of education and the number of suicide attempts were higher (p=.011 and .043, respectively). Although not significant, subthreshold depressive symptoms in interepisodic periods, the lifetime history of antidepressant use and the total number of lifetime depressive episodes tended to be more frequent in bipolar disorder with ADHD comorbidity group than in the control group.
Bipolar disorder has a frequent comorbidity with ADHD, and contrary to expectations, it might be related to the depressive aspect, rather than the manic aspect, of bipolar disorder. Early diagnosis of ADHD comorbidity in bipolar patients might help to prevent serious risk factors.
本研究的目的是确定双相情感障碍患者中成人注意力缺陷多动障碍（ADHD）共病的频率，并研究这种共病对双相情感障碍（BD）临床特征的影响。
本研究共纳入135例I型和II型双相情感障碍患者以及未另行指定的双相情感障碍患者。首先，对所有患者使用基于《精神疾病诊断与统计手册》第四版（DSM-IV）的成人注意力缺陷多动障碍诊断筛查与评定量表（ADHD量表），并对所有患者进行诊断访谈。根据DSM-IV诊断为患有ADHD共病的患者（n = 23）和未诊断为患有ADHD共病的患者（n = 32）在社会人口统计学和临床相关性方面进行比较。
135例患者中有23例（17%）被发现患有ADHD共病。在ADHD共病组中，受教育程度和自杀未遂次数更高（分别为p = 0.011和0.043）。虽然不显著，但双相情感障碍合并ADHD共病组在发作间期的阈下抑郁症状、终身使用抗抑郁药史以及终身抑郁发作总数往往比对照组更频繁。
双相情感障碍常与ADHD共病，与预期相反，它可能与双相情感障碍抑郁方面而非躁狂方面有关。双相情感障碍患者中ADHD共病的早期诊断可能有助于预防严重危险因素。
