Schiweck Carmen, Arteaga-Henriquez Gara, Aichholzer Mareike, Edwin Thanarajah Sharmili, Vargas-Cáceres Sebastian, Matura Silke, Grimm Oliver, Haavik Jan, Kittel-Schneider Sarah, Ramos-Quiroga Josep Antoni, Faraone Stephen V, Reif Andreas
Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany.
Department for Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain.
Neurosci Biobehav Rev. 2021 May;124:100-123. doi: 10.1016/j.neubiorev.2021.01.017. Epub 2021 Jan 27.
Attention-deficit / hyperactivity disorder (ADHD) and Bipolar Disorder (BD) are common mental disorders with a high degree of comorbidity. However, no systematic review with meta-analysis has aimed to quantify the degree of comorbidity between both disorders. To this end we performed a systematic search of the literature in October 2020. In a meta-analysis of 71 studies with 646,766 participants from 18 countries, it was found that about one in thirteen adults with ADHD was also diagnosed with BD (7.95 %; 95 % CI: 5.31-11.06), and nearly one in six adults with BD had ADHD (17.11 %; 95 % CI: 13.05-21.59 %). Substantial heterogeneity of comorbidity rates was present, highlighting the importance of contextual factors: Heterogeneity could partially be explained by diagnostic system, sample size and geographical location. Age of BD onset occurred earlier in patients with comorbid ADHD (3.96 years; 95 % CI: 2.65-5.26, p < 0.001). Cultural and methodological differences deserve attention for evaluating diagnostic criteria and clinicians should be aware of the high comorbidity rates to prevent misdiagnosis and provide optimal care for both disorders.
注意缺陷多动障碍（ADHD）和双相情感障碍（BD）是常见的精神障碍，共病率很高。然而，尚无系统评价和荟萃分析旨在量化这两种障碍之间的共病程度。为此，我们于2020年10月对文献进行了系统检索。在一项对来自18个国家的71项研究、646,766名参与者的荟萃分析中，发现约每13名患有ADHD的成年人中就有1人也被诊断为BD（7.95%；95%CI：5.31-11.06），近六分之一患有BD的成年人患有ADHD（17.11%；95%CI：13.05-21.59%）。共病率存在显著异质性，突出了背景因素的重要性：异质性部分可由诊断系统、样本量和地理位置来解释。BD发病年龄在ADHD共病患者中更早（3.96岁；95%CI：2.65-5.26，p<0.001）。文化和方法学差异在评估诊断标准时值得关注，临床医生应意识到高共病率，以防止误诊并为两种障碍提供最佳治疗。
