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Common psychiatric and metabolic comorbidity of adult attention-deficit/hyperactivity disorder: A population-based cross-sectional study
Open accessAbstract
Attention-deficit/hyperactivity disorder (ADHD) is often comorbid with other psychiatric conditions in adults. Yet, less is known about its relationship with common metabolic disorders and how sex and ageing affect the overall comorbidity patterns of adult ADHD. We aimed to examine associations of adult ADHD with several common psychiatric and metabolic conditions. Through the linkage of multiple Swedish national registers, 5,551,807 adults aged 18 to 64 years and living in Sweden on December 31, 2013 were identified and assessed for clinical diagnoses of adult ADHD, substance use disorder (SUD), depression, bipolar disorder, anxiety, type 2 diabetes mellitus (T2DM), and hypertension. Logistic regression models and regression standardization method were employed to obtain estimates of prevalence, prevalence difference (PD), and prevalence ratio (PR). All comorbid conditions of interest were more prevalent in adults with ADHD (3.90% to 44.65%) than in those without (0.72% to 4.89%), with the estimated PRs being over nine for psychiatric conditions (p < 0.001) and around two for metabolic conditions (p < 0.001). Sex differences in the prevalence of comorbidities were observed among adults with ADHD. Effect modification by sex was detected on the additive scale and/or multiplicative scale for the associations of adult ADHD with all comorbidities. ADHD remained associated with all comorbidities in older adults aged 50 to 64 when all conditions were assessed from age 50 onwards. The comorbidity patterns of adult ADHD underscore the severity and clinical complexity of the disorder. Clinicians should remain vigilant for a wide range of psychiatric and metabolic problems in ADHD affected adults of all ages and both sexes.
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“Emerging evidence also suggests links between the condition in question and metabolic disorders, including obesity”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [15]
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Metadata
- Authors
- Chen, Q., Hartman, C. A., Haavik, J., Harro, J., Klungsøyr, K., Hegvik, T.-A., Wanders, R., Ottosen, C., Dalsgaard, S., Faraone, S. V., & Larsson, H.
- Affiliations
- Karolinska Institutet (SE)
- University Medical Center Groningen (NL)
- Haukeland University Hospital (NO)
- University of Tartu (EE)
- Norwegian Institute of Public Health (NO)
- Aarhus University (DK)
- SUNY Upstate Medical University (US)
- Örebro University (SE)
- Corresponding author
- Chen, Qi
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-09-26
- Volume
- 13
- Issue
- 9
- Pages
- e0204516
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6157884
- OpenAlex
- W2893086897
- Cited by
- 236
- References
- 48
- Citations by year
- 2026: 28 · 2025: 31 · 2024: 41 · 2023: 35 · 2022: 29 · 2021: 30 · 2020: 29 · 2019: 12 · 2018: 1
- FWCI
- 14.12
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Funders
- Vetenskapsrådet (2014-3831)
- Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM) framework (340-2013-5867)
- The European Union’s Horizon 2020 research and innovation programme (667302)
- The K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
- The European Union’s Seventh Framework Programme for research, technological development and demonstration (602805)
- The European Union’s Horizon 2020 research and innovation programme under grant agreements (728018)
- National Institute of Mental Health (5R01MH101519 & U01 MH109536-01)
- Aarhus University Foundation Associate Professor Starting Grant (AUFF-E-2015-FLS-8-61)
- The Novo Nordisk Foundation (NNF 22018)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- adult ADHD, psychiatric comorbidity, metabolic comorbidities, substance use disorders, depression, bipolar disorder, anxiety, type 2 diabetes, hypertension, sex differences, aging, prevalence
- MeSH terms
- Adolescent, Adult, Anxiety, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Bipolar Disorder, Cross-Sectional Studies, Depressive Disorder, Diabetes Mellitus, Type 2, Female, Humans, Hypertension, Male, Metabolic Diseases, Middle Aged, Sex Factors, Sweden, Comorbidity, Prevalence, Substance-Related Disorders, Young Adult
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