Bipolar symptoms in adult attention-deficit/hyperactivity disorder: a cross-sectional study of 510 clinically diagnosed patients and 417 population-based controls

J Clin Psychiatry. 2010 Jan;71(1):48-57. doi: 10.4088/JCP.08m04722ora.

Abstract

Objective: Bipolar spectrum disorders (BSD) have several symptoms and features in common with attention-deficit/hyperactivity disorder (ADHD). Here we explored the prevalence of BSD and the relationship between symptoms of BSD and ADHD in adult ADHD patients.

Method: Norwegian adults diagnosed with DSM-IV ADHD during 1997 through 2007 (n = 510) and a random sample of 417 controls from the general population (aged 18-40 years) were recruited and responded to 85 questions rating symptoms of ADHD, lifetime symptoms of mood disorders, other comorbid conditions, and sociodemographic data.

Results: According to the Mood Disorder Questionnaire (MDQ), 50.6% of the ADHD patients screened positive for BSD, compared to 8.3% of the controls. In comparison, the prevalence of BSD according to DSM-IV in a subsample of interviewed patients (n = 50) was 32%. In the whole study sample (N = 927), an ADHD diagnosis was the strongest predictor for screening positive on the MDQ (OR = 5.0, P < .001), but the correlation between dimensional symptom levels of ADHD and of BSD was strongest in the control group (Pearson correlation r = 0.7, P < .001 vs r = 0.3, P < .001). Patients screening positive on the MDQ had significantly more drug problems, higher ADHD symptom scores, and lower educational and occupational levels.

Conclusions: Our findings illustrate the close relationship between some symptoms of BSD and ADHD in adults. In clinical and research settings, patients screening positive for BSD should be assessed for a possible underlying or coexisting ADHD condition and vice versa.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Attention Deficit Disorder with Hyperactivity / complications*
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Bipolar Disorder / complications*
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / psychology
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Diagnosis, Differential
  • Female
  • Humans
  • Logistic Models
  • Male
  • Psychiatric Status Rating Scales
  • Socioeconomic Factors
  • Young Adult