Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Nova Scotia Health Authority, Halifax, NS, Canada.
Acta Psychiatr Scand. 2021 May;143(5):380-391. doi: 10.1111/acps.13283. Epub 2021 Feb 15.
Attention-deficit/hyperactivity disorder (ADHD) in mood disorders is associated with unfavorable outcomes, including more frequent mood episodes, and increased risk of suicide. The reported prevalence of ADHD in individuals with mood disorders varies widely.
We searched PsycInfo and PubMed for articles published before September 21 , 2020, using search terms for ADHD and mood disorders. We included original data on the prevalence of ADHD in individuals with bipolar disorder (BD) or major depressive disorder (MDD). We estimated the prevalence of ADHD, by developmental period and disorder using random-effects meta-analyses. We also compared the rate of ADHD in people with MDD and BD, and with and without mood disorders.
Based on 92 studies including 17089 individuals, prevalence of ADHD in BD is 73% (95% CI 66-79) in childhood, 43% (95% CI 35-50) in adolescence, and 17% (95% CI 14-20) in adulthood. Data from 52 studies with 16897 individuals indicated that prevalence of ADHD in MDD is 28% (95% CI 19-39) in childhood, 17% (95% CI 12-24) in adolescence, and 7% (95% CI 4-11) in adulthood. ADHD was three times more common in people with mood disorders compared to those without and 1.7 times more common in BD compared to MDD.
People with mood disorders are at a significant risk for ADHD. ADHD should be assessed and treated in individuals with BD and MDD. Comprehensive assessment strategies are needed to address challenges of diagnosing ADHD alongside mood disorders.
心境障碍中的注意缺陷多动障碍(ADHD)与不良结局相关,包括更频繁的心境发作和自杀风险增加。心境障碍患者中 ADHD 的报告患病率差异很大。
我们使用 ADHD 和心境障碍的搜索词,在 2020 年 9 月 21 日之前在 PsycInfo 和 PubMed 上搜索了文章。我们纳入了关于双相情感障碍(BD)或重性抑郁障碍(MDD)患者中 ADHD 患病率的原始数据。我们使用随机效应荟萃分析,按发育阶段和疾病估计 ADHD 的患病率。我们还比较了 MDD 和 BD 患者以及有和无心境障碍患者中 ADHD 的发生率。
基于包括 17089 名个体的 92 项研究,BD 中 ADHD 的患病率在儿童期为 73%(95%CI 66-79),在青春期为 43%(95%CI 35-50),在成年期为 17%(95%CI 14-20)。来自 52 项包含 16897 名个体的研究的数据表明,MDD 中 ADHD 的患病率在儿童期为 28%(95%CI 19-39),在青春期为 17%(95%CI 12-24),在成年期为 7%(95%CI 4-11)。与无心境障碍的个体相比,有心境障碍的个体中 ADHD 的发病率高 3 倍,与 MDD 相比,BD 高 1.7 倍。
心境障碍患者发生 ADHD 的风险显著增加。BD 和 MDD 患者应评估和治疗 ADHD。需要综合评估策略来解决同时诊断 ADHD 和心境障碍的挑战。