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Cited by 110Attention Deficit Hyperactivity DisorderObsessive-Compulsive Spectrum DisordersSchizophrenia research and treatment

Adult ADHD and comorbid depression: A consensus-derived diagnostic algorithm for ADHD

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Binder, Carin, McIntosh, Kutcher, Stan, Levitt, Rosenbluth, Fallu·2009·Neuropsychiatric Disease and Treatment
DOI 10.2147/ndt.s4720PMC PMC2695217
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Abstract

OBJECTIVE: Many patients present to their physician with depression as their primary symptom. However, depression may mask other comorbid disorders. This article presents diagnostic criteria and treatment recommendations (and monitoring) pertaining to the diagnosis of adult attention deficit hyperactivity disorder (ADHD), which may be missed in patients who present with depressive symptoms, or major depressive disorder (MDD). Other co-occurring conditions such as anxiety, substance use, and bipolar disorder are briefly discussed. METHODS: A panel of psychiatrist-clinicians with expertise in the area of child and adolescent ADHD and mood disorders, adult mood disorders, and adult ADHD was convened. A literature search for recommendations on the diagnosis and treatment of co-occurring conditions (MDD, anxiety symptoms, and substance use) with adult ADHD was performed. Based on this, and the panel's clinical expertise, the authors developed a diagnostic algorithm and recommendations for the treatment of adult ADHD with co-occurring MDD. RESULTS: Little information exists to assist clinicians in diagnosing ADHD co-occurring with other disorders such as MDD. A three-step process was developed by the panel to aid in the screening and diagnosis of adult ADHD. In addition, comorbid MDD, bipolar disorder, anxiety symptoms, substance use and cardiovascular concerns regarding stimulant use are discussed. CONCLUSION: This article provides clinicians with a clinically relevant overview of the literature on comorbid ADHD and depression and offers a clinically useful diagnostic algorithm and treatment suggestions.

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  • Some existing ADHD medications have been associated with mood fluctuations that may exacerbate the severity of symptoms in patients with ADHD and comorbid anxiety or depression.

    “Treatment options that target symptoms of both ADHD and psychiatric comorbidities may be explored,10,28 taking into account potential drug-drug interactions or adverse effects of medications, as some existing ADHD medications have been associated with mood fluctuations that may exacerbate the severity of symptoms in patients with ADHD and comorbid anxiety or depression.7,10”

    From Health care resource utilization and costs associated with psychiatric comorbidities in adult patients with attention-deficit/ hyperactivity disorder (2024) · cites this paper as [10]

    In “ADHD with comorbid depression” (page not provided), the paper says ADHD medications may have behavioral side effects and advises monitoring the patient’s depressive state. It does not specifically report medication-associated mood fluctuations or say they exacerbate symptoms in patients with comorbid anxiety or depression. (LLM, conf=0.84)

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Cited by

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Authors
Binder, C., McIntosh, Kutcher, S., Levitt, Rosenbluth, & Fallu
Affiliations
  • Janssen Canada (Canada) (CA)
  • Dalhousie University (CA)
  • Sunnybrook Health Science Centre (CA)
  • University of Toronto (CA)
ORCID
Kutcher, Stan
Venue
Neuropsychiatric Disease and Treatment
Publisher
Informa UK Limited
Published
2009-03
Volume
5
Pages
137
ISSN
1176-6328 (ISSN-L)
DOI
10.2147/ndt.s4720
PMC
PMC2695217
OpenAlex
W1970848658
Cited by
110
References
18
Citations by year
2026: 6 · 2025: 16 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 8 · 2020: 8 · 2019: 9 · 2018: 5 · 2017: 6 · 2016: 7 · 2015: 5 · 2014: 4 · 2013: 6 · 2012: 3
FWCI
1.96
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Neuropsychiatric Disease and Treatment (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
Funders
  • Eli Lilly and Company
  • GlaxoSmithKline
  • Sanofi
  • Servier
  • H. Lundbeck A/S
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
adult ADHD, comorbid depression, major depressive disorder, diagnostic algorithm, ADHD screening, bipolar disorder, anxiety symptoms, substance use, stimulant use, cardiovascular risk, treatment guidelines, consensus panel

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