Childhood and adult attention deficit hyperactivity disorder symptoms in fibromyalgia: associations with depression, anxiety and disease impact

Hakan Karaş; Halil Çetingök; Reşat İlişer; Elif Çarpar; Muzaffer Kaşer

doi:10.1080/13651501.2020.1764585

Childhood and adult attention deficit hyperactivity disorder symptoms in fibromyalgia: associations with depression, anxiety and disease impact

Int J Psychiatry Clin Pract. 2020 Sep;24(3):257-263. doi: 10.1080/13651501.2020.1764585. Epub 2020 May 13.

Authors

Hakan Karaş¹, Halil Çetingök², Reşat İlişer³, Elif Çarpar¹, Muzaffer Kaşer^{4

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Affiliations

¹ Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey.
² Department of Algology, Istanbul University Medical Faculty, Istanbul, Turkey.
³ Fizyorom Physical Therapy and Rehabilitation Center, Diyarbakır, Turkey.
⁴ Department of Psychiatry, University of Cambridge, Cambridge, UK.
⁵ Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
⁶ Department of Psychiatry, Bahçeşehir University, Istanbul, Turkey.

PMID: 32401570
DOI: 10.1080/13651501.2020.1764585

Abstract

Objective: The first aim of this study was to determine the prevalence of childhood and current attention deficit hyperactivity disorder (ADHD) symptoms in patients with fibromyalgia. The second aim is to assess the role of depression and anxiety on the relationship between childhood and adult ADHD symptoms with disease impact in this population.Methods: Sixty-four patients with fibromyalgia were compared to matched 58 healthy controls. All participants completed the Wender Utah Rating Scale (WURS), Adult ADHD Self-Report Scale (ASRS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Fibromyalgia Impact Questionnaire (FIQ).Results: Patients with fibromyalgia had significantly higher mean scores of depression (BDI), anxiety (BAI), childhood ADHD symptoms (WURS) and adult ADHD symptoms (ASRS total, ASRS hyperactivity/impulsivity subscale and ASRS attention deficit subscale) than the control group. Fibromyalgia impact (FIQ) was significantly correlated with depression (BDI; r = 0.57, p < .001), anxiety (BAI; r = 0.56, p < .001) and childhood ADHD symptoms (WURS; r = 0.41, p < .001) in fibromyalgia group. There was no significant correlation between fibromyalgia impact (FIQ) and adult ADHD symptoms (ASRS total or sub-scale scores). Hierarchical multiple regression indicated that childhood ADHD symptoms (WURS), anxiety (BAI) and depression (BDI) predicted fibromyalgia impact. Both anxiety (BAI) and depression (BDI) mediated the relationship between childhood ADHD symptoms (WURS) and fibromyalgia impact (FIQ).Conclusion: Childhood ADHD symptoms may be a contributory factor to poorer functioning in the patients with fibromyalgia. The relationship was more pronounced in the presence of depression and anxiety symptoms. Evaluation of childhood and adult ADHD symptoms in patients with fibromyalgia is important for recognition and treatment of ADHD comorbidity and also for attenuating the severity of the disease.

Keywords: ADHD symptoms; Fibromyalgia; anxiety; attention deficit and hyperactivity; depression; fibromyalgia impact.

MeSH terms

Adult
Anxiety / epidemiology
Anxiety / physiopathology*
Attention Deficit Disorder with Hyperactivity / epidemiology
Attention Deficit Disorder with Hyperactivity / physiopathology*
Child
Comorbidity
Depression / epidemiology
Depression / physiopathology*
Female
Fibromyalgia / epidemiology
Fibromyalgia / physiopathology*
Humans
Middle Aged
Prevalence