Skip to main content

Advertisement

Log in

ADHD and the Development of Depression: Commentary on the Prevalence, Proposed Mechanisms, and Promising Interventions

  • Invited Commentary
  • Published:
Current Developmental Disorders Reports Aims and scope Submit manuscript

Abstract

Attention-deficit/hyperactivity disorder (ADHD) has been identified as a significant risk factor for the development of later depression. Furthermore, their comorbid presentation results in greater levels of impairment than either disorder in isolation. Research has pointed to several causal mechanisms by which ADHD co-occurs with depression including the persistence of ADHD symptoms, reward responsivity, and emotion dysregulation as well as parenting/family factors and maternal depression. Stemming from this mechanistic research, interventions have been developed in recent years that aim to prevent depression in youth with ADHD. The Behaviorally Enhancing Adolescents Mood (BEAM) Program and The Integrated Parenting Intervention for ADHD (IPI-A) have both demonstrated promising results. Directions for future research are discussed with an emphasis on neurobiological mechanisms and the dissemination/implementation of interventions to reduce risk for depression among youth with ADHD in community care settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Hechtman L, Swanson JM, Sibley MH, Stehli A, Owens EB, Mitchell JT, MTA Cooperative Group. Functional adult outcomes 16 years after childhood diagnosis of attention-deficit/hyperactivity disorder: MTA results. J Am Acad Child Adolesc Psychiatry. 2016;55:945–52. doi:10.1016/j.jaac.2016.07.774.

    Article  PubMed  Google Scholar 

  2. Meinzer MC, Lewinsohn PM, Pettit JW, Seeley JR, Gau JM, Chronis-Tuscano A, Waxmonsky JG. Attention-deficit/hyperactivity disorder in adolescence predicts onset of major depressive disorder through early adulthood. Depress Anxiety. 2013;30:546–53. doi:10.1002/da.22082.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Biederman J, Mick E, Faraone SV. Depression in attention deficit hyperactivity disorder (ADHD) children: “true” depression or demoralization? J Affect Disord. 1998;47:113–22.

    Article  CAS  PubMed  Google Scholar 

  4. Chronis-Tuscano A, Molina BS, Pelham WE, Applegate B, Dahlke A, Overmyer M, Lahey BB. Very early predictors of adolescent depression and suicide attempts in children with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 2010;67:1044–51.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Meinzer MC, Pettit JW, Waxmonsky JG, Gnagy E, Molina BSG, Pelham WE. Does childhood attention-deficit/hyperactivity disorder (ADHD) predict levels of depressive symptoms during emerging adulthood. J Abnorm Child Psychol. 2016;44:787–97. doi:10.1007/s10802-015-0065-0.

    Article  PubMed  Google Scholar 

  6. Meinzer MC, Pettit JW, Viswesvaran C. The co-occurrence of attention-deficit/hyperactivity disorder and unipolar depression in children and adolescents: a meta-analytic review. Clin Psychol Rev. 2014;2014(34):569–607. doi:10.1016/j.cpr.2014.10.002.

    Google Scholar 

  7. Daviss B. A review of co-morbid depression in pediatric ADHD: etiologies, phenomenology, and treatment. J Child Adolesc Psychopharmacol. 2008;18:565–71. doi:10.1089/cap.2008.032.

    Article  PubMed  PubMed Central  Google Scholar 

  8. James A, Lai FH, Dahl C. Attention deficit hyperactivity disorder and suicide: a review of possible associations. Acta Psychiatr Scand. 2004;2004(110):408–15. doi:10.1111/j.1600-0447.2004.00384.x.

    Article  Google Scholar 

  9. Pearcy MT, Clopton JR, Pope AW. Influences on teacher referral of children to mental health services: gender, severity, and internalizing vs. externalizing problems. J Emot Behav Disord. 1993;1:165–9.

    Article  Google Scholar 

  10. Thurston IB, Phares V, Coates EE, Bogart LM. Child problem recognition and help-seeking intentions among black and white parents. J Clin Child Adolesc Psychol. 2015;44:604–15. doi:10.1080/15374416.2014.883929.

    Article  PubMed  Google Scholar 

  11. Humphreys KL, Katz SJ, Lee SS, Hammen C, Brennan PA, Najman JM. The association of ADHD and depression: mediation by peer problems and parent-child difficulties in two complementary samples. J Abnorm Psychol. 2013;122:854–67. doi:10.1037/a0033895.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bogdan R, Pizzagalli DA. The heritability of hedonic capacity and perceived stress: a twin study evaluation of candidate depressive phenotypes. Psychol Med. 2009;2009(39):211–8. doi:10.1017/S0033291708003619.

    Article  Google Scholar 

  13. Scheres A, Milham MP, Knutson B, Castellanos FX. Ventral striatal hyporesponsiveness during reward anticipation in attention-deficit/hyperactivity disorder. Biol Psychiatry. 2007;61:720–4.

    Article  PubMed  Google Scholar 

  14. Wood AC, Neale MC. Twin studies and their implications for molecular genetic studies: endophenotypes integrate quantitative and molecular genetics in ADHD research. J Am Acad Child Adolesc Psychiatry. 2010;49:874–83. doi:10.1016/j.jaac.2010.06.006.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Forbes EE. Where’s the fun in that? Broadening the focus on reward function in depression. Biol Psychiatry. 2009;66:199–200.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kato T. Molecular genetics of bipolar disorder and depression. Psychiatry Clin Neurosci. 2007;2007(61):3–19. doi:10.1111/j.1440-1819.2007.01604.x.

    Article  Google Scholar 

  17. Meinzer MC, Pettit JW, Leventhal AM, Hill RM. Explaining the covariance between attention-deficit hyperactivity disorder symptoms and depressive symptoms: the role of hedonic responsivity. J Clin Psychol. 2012;68:1111–21. doi:10.1002/jclp.21884.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Norvilitis JM, Casey RJ, Brooklier KM, Bonello PJ. Emotion appraisal in children with attention deficit/hyperactivity disorder and their parents. J Atten Disord. 2000;4:15–26. doi:10.1177/108705470000400102.

    Article  Google Scholar 

  19. Walcott CM, Landau S. The relation between disinhibition and emotion regulation in boys with attention deficit hyperactivity disorder. J Clin Child Adol Psychol. 2004;33:772–82.

    Article  Google Scholar 

  20. Durbin C, Shafir D. Emotion regulation and risk for depression. In: Abela JRZ, Hankin BL, editors. Handbook of depression in children and adolescents. New York: Guilford; 2008.

    Google Scholar 

  21. Tortella-Feliu M, Balle M, Sese A. Relationships between negative affectivity, emotion regulation, anxiety, and depressive symptoms in adolescents as examined through structural equation modeling. J Anxiety Disord. 2010;24:686–93. doi:10.1016/j.janxdis.2010.04.012.

    Article  PubMed  Google Scholar 

  22. Anastopoulos AD, Smith TF, Garrett ME, Morrissey-Kane E, Schatz NK, Sommer JL, Ashley-Koch A. Self-regulation of emotion, functional impairment, and comorbidity among children with AD/HD. J Atten Disord. 2011;15:583–92. doi:10.1177/1087054710370567.

    Article  PubMed  Google Scholar 

  23. Seymour KE, Chronis-Tuscano A, Halldorsdottir T, Stupica B, Owens K, Sacks T. Emotion regulation mediates the relationship between ADHD and depressive symptoms in youth. J Abnorm Child Psychol. 2012;40:595–606. doi:10.1007/s10802-011-9593-4.

    Article  PubMed  Google Scholar 

  24. Seymour KE, Chronis-Tuscano A, Iwamoto DK, Kurdziel G, Macpherson L. Emotion regulation mediates the association between ADHD and depressive symptoms in a community sample of youth. J Abnorm Child Psychol. 2014;42:611–21. doi:10.1007/s10802-013-9799-8.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ostrander R, Herman K. C. Potential cognitive, parenting, and developmental mediators of the relationship between ADHD and depression. J Consult Clin Psychol. 2006;74:89–98. doi:10.1037/0022-006x.74.1.89.

    Article  PubMed  Google Scholar 

  26. Meinzer MC, Hill RM, Pettit JW, Nichols-Lopez KA. ADHD symptoms predict depressive symptoms in college students via low parental support. J Psychopathol Behav Assess. 2015;37:247–55. doi:10.1007/s10862-014-9449-7.

    Article  Google Scholar 

  27. Chronis AM, Lahey BB, Pelham WE, Williams SH, Baumann BL, Kipp H, Rathouz PJ. Maternal depression and early positive parenting predict future conduct problems in young children with attention-deficit/hyperactivity disorder. Dev Psychol. 2007;43:70–82. doi:10.1037/0012-1649.43.1.70.

    Article  PubMed  Google Scholar 

  28. Chronis AM, Lahey BB, Pelham WE, Kipp HL, Baumann B, Lee SS. Psychopathology and substance abuse in parents of young children with attention-deficit/hyperactivity disorder. J Amer Acad Child Adolesc Psychiatry. 2003;42:1424–32.

    Article  Google Scholar 

  29. Fabiano GA, Hulme K, Linke A, Nelson-Tuttle C, Pariseau M, Gangloff B, Gormley M. The supporting a teen’s effective entry to the roadway (STEER) program: feasibility and preliminary support for a psychosocial intervention for teenage drivers with ADHD. Cog Behav Pract. 2011;18:267–80. doi:10.1016/j.cbpra. 2010.04.002.

    Article  Google Scholar 

  30. Schatz NK, Pelham WE, Winters KC. Early intervention for adolescents with ADHD and substance use. Symposium presented at: Association for Behavioral and Cognitive Therapies Annual Meeting; November. Chicago, IL. 2015.

  31. Meinzer MC, Hartley CM, Hoogesteyn K, Pettit JW. Development and open trial of a depression preventive intervention for adolescents with attention-deficit/hyperactivity disorder. Cog Behav Pract Under Review.

  32. Pottick KJ, Bilder S, Vander Stoep A, Warner LA, Alvarez MF. US patterns of mental health service utilization for transition-age youth and young adults. J Behav Health Service Res. 2008;35:373–89.

    Article  Google Scholar 

  33. Kataoka SH, Zhang L, Wells KB. Unmet need for mental health care among U.S. children: variation by ethnicity and insurance status. Am J Psychiatry. 2002;159:1548–55. doi:10.1176/appi.ajp.159.9.1548.

    Article  PubMed  Google Scholar 

  34. Paternite CE. School-based mental health programs and services: overveiw and introduction to the special issue. J Abnorm Child Psychol. 2005;33:657–63. doi:10.1007/s10802-005-7645-3.

    Article  PubMed  Google Scholar 

  35. Chronis AM, Gamble SA, Roberts JE, Pelham WE. Cognitive-behavioral depression treatment for mothers of children with attention-deficit/hyperactivity disorder. Behav Ther. 2006;37:143–58. doi:10.1016/j.beth.2005.08.001.

    Article  PubMed  Google Scholar 

  36. Cuijpers P, Muñoz RF, Clarke GN, Lewinsohn PM. Psychoeducational treatment and prevention of depression: the “coping with depression” course thirty years later. Clin Psychol Rev. 2009;29:449–58. doi:10.1016/j.cpr.2009.04.005.

    Article  PubMed  Google Scholar 

  37. Chronis-Tuscano A, Clarke TL, O’Brien KA, Raggi VL, Diaz Y, Lewinsohn P. Development and preliminary evaluation of an integrated treatment targeting parenting and depressive symptoms in mothers of children with attention-deficit/hyperactivity disorder. J Consult Clin Psychol. 2013;81:918–25. doi:10.1037/a0032112.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Molina BSG, Pelham WE. Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD. J Abnorm Psychol. 2003;112:497–507.

    Article  PubMed  Google Scholar 

  39. Sibley MH, Pelham WE, Molina BSG, Gnagy EM, Waschbusch DA, Karch KM. The delinquency outcomes of boys with ADHD with and without comorbidity. J Abnorm Child Psychol. 2011;39:21–32. doi:10.1007/s10802-010-9443-9.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Seymour KE, Pescosolido MF, Reidy BL, Galvan T, Kim KL, Young M, Dickstein DP. Emotional face identification in youths with primary bipolar disorder or primary attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2003;52:537–46. doi:10.1016/j.jaac.2013.03.011.

    Article  Google Scholar 

  41. Seymour KE, Miller L. ADHD and depression: The role of poor frustration tolerance. Curr Dev Disord Rep. 2017. doi:10.1007/s40474-017-0105-2.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrea Chronis-Tuscano.

Ethics declarations

Conflict of Interest

Michael C. Meinzer reports loan payment grant from NIMH.

Andrea Chronis-Tuscano reports grants from NIMH (R03 MH070666-1, R34 MH073567-01A1, R34 MH 099208-01), NIAAA (R34 AA--22133-A1), and McNeil Pediatrics and study drug donation from Shire Pharmaceuticals.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Meinzer, M.C., Chronis-Tuscano, A. ADHD and the Development of Depression: Commentary on the Prevalence, Proposed Mechanisms, and Promising Interventions. Curr Dev Disord Rep 4, 1–4 (2017). https://doi.org/10.1007/s40474-017-0106-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40474-017-0106-1

Keywords

Navigation