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ADHD and comorbid depression

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Current Attention Disorders Reports

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is prevalent, chronic, and often comorbid with other disorders. This article reviews the literature on ADHD and comorbid major depressive disorder from childhood through adolescence and adulthood. We also report findings from a study we conducted that examined the prevalence of ADHD and comorbid major depression in adults. Diagnostic history data were analyzed in 524 adults (308 men; 216 women), 383 of whom had a diagnosis of ADHD. Adults with ADHD were more likely to have current major depression than adults without ADHD. Adults with the combined subtype of ADHD were more likely to have past and current major depression than those with the inattentive and hyperactive impulsive subtypes. Men and women with ADHD were more likely to have current major depression than men and women without ADHD, but women in the inattentive and combined subtype groups were more likely to have had past major depression than women in the hyperactive impulsive subtype group. Implications for diagnosis and treatment are discussed.

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References and Recommended Reading

  1. Faraone S, Sergeant J, Gillberg C, Biederman J: The worldwide prevalence of ADHD: Is it an American condition? World Psychiatry 2003, 2:104–113.

    PubMed  Google Scholar 

  2. Sciutto MJ, Eisenberg M: Evaluating the evidence for and against the overdiagnosis of ADHD. J Atten Disord 2007, 11:106–113.

    Article  PubMed  Google Scholar 

  3. Harpin VA: The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Arch Dis Child 2005, 90:i2–i7.

    Article  PubMed  Google Scholar 

  4. Hechtman L: Attention deficit disorders. In Comprehensive Textbook of Psychiatry, vol 2. Edited by Sadock BJ, Sadock VA. Philadelphia: Lippincott Williams & Wilkins; 2005:3183–3198.

    Google Scholar 

  5. Mannuzza S, Klein RG, Bessler A, et al.: Adult outcome of hyperactive boys, educational achievement, occupational rank, and psychiatric status. Arch Gen Psychiatry 1993, 50:565–576.

    PubMed  CAS  Google Scholar 

  6. Barkley R, Fischer M, Smallish L, Fletcher K: The persistence of attention deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. J Abnorm Psychol 2002, 111:279–289.

    Article  PubMed  Google Scholar 

  7. Eakin L, Minde K, Hechtman L, et al.: The marital and family functioning of adults with ADHD and their spouses. J Atten Disord 2004, 8:1–10.

    Article  PubMed  CAS  Google Scholar 

  8. Wasserstein J: Diagnostic issues for adolescents and adults with ADHD. J Clin Psychol 2005, 61:535–547.

    Article  PubMed  Google Scholar 

  9. Murphy K: Psychosocial treatments for ADHD in teens and adults: a practice-friendly review. J Clin Psychol 2005, 61:607–619.

    Article  PubMed  Google Scholar 

  10. Kessler RC, Adler LA, Barkley R, et al.: The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychol 2006, 163:611–627.

    Article  Google Scholar 

  11. Faraone S, Biederman J: What is the prevalence of adult ADHD? Results of a population screen of 966 adults. J Atten Disord 2005, 5:384–391.

    Article  Google Scholar 

  12. Weiss M, Murray C, Weiss G: Adults with attention-deficit/hyperactivity disorder: current concepts. J Psychiatr Pract 2002, 8:99–111.

    Article  PubMed  Google Scholar 

  13. Brassett-Harknett A, Butler N: Attention-deficit/hyperactivity disorder: an overview of the etiology and a review of the literature relating to the correlates and lifecourse outcomes for men and women. Clin Psychol Rev 2007, 27:188–210.

    Article  PubMed  Google Scholar 

  14. Cormier E: Attention deficit/hyperactivity disorder: a review and update. J Pediatr Nurs 2008, 23:345–357.

    Article  PubMed  Google Scholar 

  15. Adler LA, Barkley RA, Wilens TE: Differential diagnosis of attention deficit hyperactivity disorder and comorbid conditions. Prim Psychiatry 2006, 13(5 Suppl 3):1–16.

    Google Scholar 

  16. Jacob CP, Romanos J, Dempfle A, et al.: Co-morbidity of adult attention-deficit/hyperactivity disorder with focus on personality traits and related disorders in a tertiary referral center. Eur Arch Psychiatry Clin Neurosci 2007, 257:309–317.

    Article  PubMed  Google Scholar 

  17. Sobanski E: Psychiatric comorbidity in adults with attention-deficit/hyperactivity disorder (ADHD). Eur Arch Psychiatry Clin Neurosci 2006, 256(1 Suppl 1):i26–i31.

    Article  PubMed  Google Scholar 

  18. Ohlmeier MD, Peters K, Te Wildt BT, et al.: Comorbidity of alcohol and substance dependence with attention deficit hyperactive disorder (ADHD). Alcohol Alcohol 2008, 43:300–304.

    PubMed  Google Scholar 

  19. Harpold T, Biederman J, Gignac M, et al.: Is oppositional defiant disorder a meaningful diagnosis in adults? Results from a large sample of adults with ADHD. J Nerv Ment Dis 2007, 195:601–605.

    Article  PubMed  Google Scholar 

  20. Marneros A: Mood disorders: epidemiology and natural history. Psychiatry 2008, 8:52–55.

    Article  Google Scholar 

  21. Nierenberg AA: Major depressive disorder: epidemiology, course of illness, and treatment. CNS Spectr 2008, 13(5 Suppl 8):4–7.

    PubMed  Google Scholar 

  22. Murray CJL: Rethinking DALYs. In The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability From Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Edited by Murray CJL, Lopez AD. Cambridge, MA: Harvard University Press and the World Health Organization; 1996:6–43.

    Google Scholar 

  23. Kessler RC, Berglund P, Demler O, et al.: The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003, 289:3095–3105.

    Article  PubMed  Google Scholar 

  24. Wade TJ, Cairney J, Pevalin DJ: Emergence of gender differences in depression during adolescence: national panel results from three countries. J Am Acad Child Adolesc Psychiatry 2002, 41:190–198.

    Article  PubMed  Google Scholar 

  25. Blackman GL, Ostrander R, Herman KC: Children with ADHD and depression: a multisource, multimethod assessment of clinical, social, and academic functioning. J Atten Disord 2005, 8:195–207.

    Article  PubMed  Google Scholar 

  26. LeBlanc N, Morin D: Depressive symptoms and associated factors in children with attention deficit hyperactivity disorder. J Child Adolesc Psychiatr Nurs 2004, 17:49–55.

    Article  PubMed  Google Scholar 

  27. Pliszka SR: Comorbidity of attention-deficit/hyperactivity disorder with psychiatric disorder: an overview. J Clin Psychiatry 1998, 59(Suppl):50–58.

    PubMed  Google Scholar 

  28. Spencer T, Biederman J, Wilens T: Attention-deficit/hyperactivity disorder and comorbidity. Pediatr Clin North Am 1999, 46:915–927.

    Article  PubMed  CAS  Google Scholar 

  29. Angold A, Costello EJ, Erkanli A: Comorbidity. J Child Psychol Psychiatry 1999, 40:57–87.

    Article  PubMed  CAS  Google Scholar 

  30. Biederman J, Faraone S, Milberger S, et al.: A prospective four year follow up study of attention deficit hyperactivity and related disorders. Arch Gen Psychiatry 1996, 53:437–446.

    PubMed  CAS  Google Scholar 

  31. Acosta MT, Arcos-Burgos M, Muenke M: Attention-deficit/hyperactivity disorder (ADHD): complex phenotype, simple genotype? Genet Med 2004, 6:1–15.

    Article  PubMed  Google Scholar 

  32. Harada Y, Satoh Y, Sakuma A, et al.: Behavioural and developmental disorders among conduct disorder. Psychiatry Clin Neurosci 2002, 56:621–625.

    Article  PubMed  Google Scholar 

  33. Volk HE, Neuman RJ, Todd R: A systematic evaluation of ADHD and comorbid psychopathology in a population-based twin sample. J Am Acad Child Adolesc Psychiatry 2005, 44:768–775.

    Article  PubMed  Google Scholar 

  34. Diler RS, Daviss WB, Lopez A, et al.: Differentiating major depressive disorder in youths with attention deficit hyperactivity disorder. J Affect Disord 2007, 102:125–130.

    Article  PubMed  Google Scholar 

  35. Karustis JL, Power TJ, Rescorla LA, et al.: Anxiety and depression in children with ADHD: unique associations with academic and social functioning. J Atten Disord 2000, 4:133–149.

    Article  Google Scholar 

  36. Bagwell CL, Molina BSG, Kashdan TB, et al.: Anxiety and mood disorders in adolescents with childhood attention-deficit/hyperactivity disorder. J Emot Behav Disord 2006, 14:178–187.

    Article  Google Scholar 

  37. Ruchkin V, Lorberg B, Koposov R, et al.: ADHD symptoms and associated psychopathology in a community sample of adolescents from the European north of Russia. J Atten Disord 2008, 12:54–63.

    Article  PubMed  Google Scholar 

  38. Daviss WB, Birmaher B, Diler RS, Mintz J: Does pharmacotherapy for attention-deficit/hyperactivity disorder predict risk of later major depression? J Child Adolesc Psychopharmacol 2008, 18:257–264.

    Article  PubMed  Google Scholar 

  39. Biederman J, Ball SW, Monuteux MC, et al.: New insights into the comorbidity between ADHD and major depression in adolescent and young adult females. J Am Acad Child Adolesc Psychiatry 2008, 47:426–434.

    Article  PubMed  Google Scholar 

  40. Biederman J, Mick E, Faraone SV: Depression in attention deficit hyperactivity disorder (ADHD) children: “true” depression or demoralization? J Affect Disord 1998, 47:113–122.

    Article  PubMed  CAS  Google Scholar 

  41. Turgay A, Ansari R: Major depression with ADHD in children and adolescents. Psychiatry 2006, 3:20–32.

    Google Scholar 

  42. Biederman J, Faraone SV, Monuteaux MC, et al.: Gender effects on attention deficit/hyperactivity disorder in adults, revisited. Biol Psychiatry 2004, 55:692–700.

    Article  PubMed  Google Scholar 

  43. Biederman J, Faraone SV, Spencer T, et al.: Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am J Psychiatry 1993, 150:1792–1798.

    PubMed  CAS  Google Scholar 

  44. Fischer AG, Bau CH, Grevet EH, et al.: The role of comorbid major depressive disorder in the clinical presentation of adult ADHD. J Psychiatr Res 2006, 41:991–996.

    Article  PubMed  Google Scholar 

  45. McGough JJ, Smalley SL, McCracken JT, et al.: Psychiatric comorbidity in adult attention deficit hyperactivity disorder: findings from multiplex families. Am J Psychiatry 2005, 162:1621–1627.

    Article  PubMed  Google Scholar 

  46. Murphy K, Barkley RA: Attention deficit hyperactivity disorder in adults: comorbidities and adaptive impairments. Comp Psychiatry 1996, 37:393–401.

    Article  CAS  Google Scholar 

  47. Murphy KM, Nierenberg AA, Laird NM, et al.: Incidence of major depression: prediction from subthreshold categories in the Stirling County Study. J Affect Disord 2002, 68:251–259.

    Article  PubMed  Google Scholar 

  48. Roy-Byrne P, Scheele L, Brinkley J, et al.: Adult attention deficit hyperactivity disorder: assessment guidelines based on clinical presentation to a specialty clinic. Compr Psychiatry 1997, 38:133–140.

    Article  PubMed  CAS  Google Scholar 

  49. Secnik K, Swensen A, Lage MH: Comorbidities and costs of adult patients diagnosed with attention deficit hyperactivity disorder. Pharmacoeconomics 2005, 23:93–102.

    Article  PubMed  Google Scholar 

  50. Barkley R, Murphy KR, Fischer M: ADHD in Adults: What the Science Says. New York: Guilford Press; 2007.

    Google Scholar 

  51. Barkley R, Murphy KR: Comorbid psychiatric disorders in adults with ADHD. The ADHD Report 2007, 15:1–7.

    Google Scholar 

  52. Hesslinger B, Tebartz van Elst L, Mochan F, Ebert D: A psychopathological study into the relationship between attention deficit hyperactivity disorder in adult patients and recurrent brief depression. Acta Psychiatr Scand 2003, 107:385–389.

    Article  PubMed  CAS  Google Scholar 

  53. Biederman J, Faraone SV, Spencer T, et al.: Gender differences in a sample of adults with attention deficit hyperactivity disorder. Psychiatry Res 1994, 53:13–29.

    Article  PubMed  CAS  Google Scholar 

  54. Mick EM, Biederman J, Santangelo S, Wypij D: The influence of gender in the familial association between ADHD and major depression. J Nerv Ment Dis 2003, 191:699–705.

    Article  PubMed  Google Scholar 

  55. Wilens TE: Pharmacotherapy of ADHD in adults. CNS Spectr 2008, 13(5 Suppl 8):11–13.

    PubMed  Google Scholar 

  56. Wechsler D: WAIS-III: Wechsler Adult Intelligence Scale Administration and Scoring Manual, edn 3. San Antonio: Psychological Corporation/Harcourt Brace; 1997.

    Google Scholar 

  57. Ward MF, Wender PH, Reimherr FW: The Wender Utah Rating Scale: an aid in the retrospective diagnosis of attention deficit hyperactivity disorder. Am J Psychiatry 1993, 150:885–890.

    PubMed  CAS  Google Scholar 

  58. Barkley RA, Murphy KR: Attention Deficit Hyperactivity Disorder: A Clinical Workbook, edn 2. New York: Guilford Press; 1998.

    Google Scholar 

  59. Conners CK, Erhart D, Sparrow E: Conners’ Adult ADHD Rating Scales. Technical Manual. New York: Multi-Health Systems; 1999.

    Google Scholar 

  60. Cumyn L, Hechtman L, French L: Comorbidity in adults with ADHD. Can J Psychiatry (in press).

  61. Conners CK, Epstein J, Johnson D: Conners’ Adult ADHD Diagnostic Interview for DSM-IV. New York: Multi-Health Systems; 2001.

    Google Scholar 

  62. First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Patient Edition (SCID-I/P). New York: New York State Psychiatric Institute; 2002.

    Google Scholar 

  63. First MB, Gibbon M, Spitzer RL, et al.: Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCIDII). Washington, DC: Amercian Psychiatric Press; 1997.

    Google Scholar 

  64. Rostain AL: Adult ADHD and depressive disorders: prevalence, significance, and clinical presentation. CNS Spectr 2008, 13(5 Suppl 8):8–10.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Montreal Children’s Hospital, McGill University, 4018 Ste. Catherine St. West, Montreal, QC, H3Z 1P2, Canada

    Lily Hechtman

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  1. Lucy Cumyn
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  2. Lisa French
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  3. Lily Hechtman
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Correspondence to Lily Hechtman.

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Cumyn, L., French, L. & Hechtman, L. ADHD and comorbid depression. Curr Atten Disord Rep 1, 53–59 (2009). https://doi.org/10.1007/s12618-009-0008-1

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