Comorbidity of ADHD and adult bipolar disorder: A systematic review and meta-analysis. (May 2021)

• Record Type: Journal Article
• Authors: 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
• Is Part Of: Neuroscience and biobehavioral reviews. Volume 124(2021)
• Page Start: 100
• Page End: 123
• Publication Date: 2021-05
• Subjects: Comorbidity -- ADHD -- Attention deficit hyperactivity disorder -- Adult bipolar disorder -- Prevalence -- Age of onset; Psychophysiology -- Periodicals; Human behavior -- Periodicals; Animal behavior -- Periodicals; Neurology -- Periodicals; Behavior -- Periodicals; Ethology -- Periodicals; Neurology -- Periodicals; Psychophysiologie -- Périodiques; Comportement humain -- Périodiques; Animaux -- Mœurs et comportement -- Périodiques; Neurologie -- Périodiques; Animal behavior; Human behavior; Neurology; Psychophysiology; Periodicals; Electronic journals; 573.8
• DOI: 10.1016/j.neubiorev.2021.01.017
• Languages: English
• ISSNs: 0149-7634

Abstract

Highlights: We conducted a meta-analysis of comorbidity between ADHD and adult BD. Up to 1 in 13 patients with ADHD has comorbid BD and up to 1 in 6 patients with BD has comorbid ADHD. Comorbidity rates are heterogeneous and differ per continent and diagnostic system. BD age of onset was nearly 4 years earlier in patients with comorbid ADHD. Careful differential diagnosis of both disorders is necessary. Abstract: 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.