Attention-Deficit/Hyperactivity Disorder in Adults With Bipolar Disorder or Major Depressive Disorder: Results From the International Mood Disorders Collaborative Project
Open accessAbstract
OBJECTIVE: Relatively few studies have evaluated the clinical implications of lifetime attention-deficit/hyperactivity disorder (ADHD) in adults with bipolar disorder or major depressive disorder (MDD). Herein, we sought to determine the prevalence as well as the demographic and clinical correlates of lifetime ADHD in persons with a mood disorder. METHOD: The first 399 patients enrolled in the International Mood Disorders Collaborative Project (IMDCP) were evaluated for lifetime ADHD using the Mini-International Neuropsychiatric Interview-Plus (MINI-Plus) as the primary instrument to derive current and lifetime DSM-IV diagnoses. All analyses of variables of interest were conducted utilizing the MINI-Plus, the Adult ADHD Self-Report Scale-v1.1, and the Wender Utah Rating Scale-Short Form. The effect of ADHD on clinical presentation, course of illness variables, comorbidity, anamnesis, treatment, and outcome are reported. The IMDCP is a joint initiative of the Mood Disorders Psychopharmacology Unit at the University Health Network, University of Toronto, Toronto, Ontario, Canada, and the Cleveland Clinic Center for Mood Disorders Treatment and Research at Lutheran Hospital, Cleveland, Ohio. All data for this study were procured between January 2008 and January 2009. RESULTS: The percentages of subjects with MDD or bipolar disorder meeting the DSM-IV criteria for lifetime adult ADHD were 5.4% and 17.6% (P < .001), respectively. Lifetime comorbid ADHD in both mood disorder populations was associated with earlier age at illness onset (MDD, P = .049; bipolar disorder, P = .005), a higher number of psychiatric comorbidities (eg, MDD and current panic disorder with agoraphobia [P = .002]; bipolar disorder and social phobia [P = .012]), and decreased quality of life (MDD, P = .018). CONCLUSIONS: The overarching findings herein are that the adult ADHD phenotype is commonly reported by individuals with MDD or bipolar disorder and is associated with a greater illness burden and complexity.
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These comorbidities present important clinical challenges since their co-occurrence results in greater disease burden and more severe illness courses than ADHD or mood and anxiety disorders alone.
“These comorbidities present important clinical challenges since their co-occurrence results in greater disease burden and more severe illness courses than ADHD or mood and anxiety disorders alone [44].”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [44]
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Jhanda, S., Malhotra, S., & Grover, S. (2018) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2018.05.015 · Cited by 8 · see citing works
fNIRS Classification of Adults With ADHD Enhanced by Feature Selection
Hong, M., Dong, S.-Y., McIntyre, R. S., Chiang, S., & Ho, R. (2024) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2024.3522121 · Cited by 7 · see citing works
Self-citationErdoğan, E., Delibaş, D. H., & Gülseren, Ş. (2019) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_448_18 · Cited by 7 · see citing works
“ADHD, the reasons for an early onset of depression have not been fully clarified.[18,36,37] When the literature is examined,”
BackgroundKato, M., Tsuda, H., Chen, Y., Tsuji, T., & Nishigaki, N. (2023) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s399915 · Cited by 6 · see citing works
“This finding is in agreement with previous research suggesting that when ADHD is comorbid with depression, individuals have a higher disease burden and a lower quality of life than those affected by MDD alone.(41) In addition, both MDD and ADHD have previously been associated with functional impairments at work,(42,43…”
ResultWalsh, R. F. L., Sheppard, B. K., Cui, L., Brown, C., Meter, A. V., & Merikangas, K. R. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.08.017 · Cited by 6 · see citing works
Huang, J., Ahlers, E., Bogatsch, H., Böhme, P., Ethofer, T., Fallgatter, A. J., Gallinat, J., Hegerl, U., Heuser, I., Hoffmann, K., et al. (2022) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-022-01452-2 · Cited by 6 · see citing works
“In selfevaluating assessments, depressed aADHD patients, when compared to patients had only ADHD, report a higher demand for previous mental health care [8], experience lower occupational functioning [9, 10] and perceive consequently lower quality of life [11].”
BackgroundLee, Y. L., Carmona, N. E., Shekotikhina, M., Subramaniapillai, M., Mansur, R. B., Cha, D. S., Lee, J.-H., Lee, J., Zhou, A. J., Dale, R. M., et al. (2018) · Annals of Clinical Psychiatry · doi:10.1177/154733251803000105 · Cited by 6 · see citing works
Self-citationPattanshetti, N., Patil, N., & Tekkalaki, B. (2016) · Indian Journal of Health Sciences and Biomedical Research (KLEU) · doi:10.4103/2349-5006.196325 · Cited by 6 · see citing works
Managing ADHD in Adults with Common Comorbidities
Sobanski, E., Paslakis, G., Schredl, M., Daffner, S., & Alm, B. (2012) · Humana Press eBooks · doi:10.1007/978-1-62703-248-3_8 · Cited by 5 · see citing works
Fountoulakis, K. N. (2014) · Springer eBooks · doi:10.1007/978-3-642-37216-2_10 · Cited by 3 · see citing works
Wang, X., Nandy, A. S., & Jadi, M. P. (2023) · Scientific Reports · doi:10.1038/s41598-023-46722-8 · Cited by 3 · see citing works
A potential diagnostic blood test for attention deficit hyperactivity disorder
Woodruff, D. B., El-Mallakh, R., & Thiruvengadam, A. (2011) · Attention deficit and hyperactivity disorders · doi:10.1007/s12402-011-0057-z · Cited by 3 · see citing works
Treatment of cognitive dysfunction in adults with major depressive disorder
McIntyre, R. S., Syeda, K., & Cha, D. S. (2015) · Cambridge University Press eBooks · doi:10.1017/cbo9781139860567.020 · Cited by 3 · see citing works
Self-citationLevy, M., Berger, A., Egotubov, A., Gordon‐Hacker, A., Sheiner, E., & Gueron‐Sela, N. (2025) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-025-01332-y · Cited by 2 · see citing works
Hess, J., Nguyen, N. H., Suben, J., Meath, R. M., Albert, A. B., Orman, S. V., Anders, K. M., Forken, P. J., Roe, C. A., Schulze, T. G., et al. (2020) · Translational Psychiatry · doi:10.1038/s41398-020-01007-w · Cited by 2 · see citing works
Assessment and treatment of depressive disorders in adults with ADHD
Prince, J. B. (2014) · Cambridge University Press eBooks · doi:10.1017/cbo9781139035491.009 · Cited by 1 · see citing works
Anxiety symptoms are distinctly related to working memory deficits in adults with ADHD
Rauch, A. A., Soble, J. R., & Silton, R. L. (2025) · Applied Neuropsychology Adult · doi:10.1080/23279095.2024.2449170 · Cited by 3 · see citing works
Shekari, H., Nahavandi, A., & Ahmadi, M. (2017) · Annals of Military and Health Sciences Research · doi:10.5812/amh.68579 · Cited by 1 · see citing works
Adult ADHD in Psychiatric Conditions
Pallanti, S., & Salerno, L. (2020) · Springer eBooks · doi:10.1007/978-3-030-39051-8_6 · Cited by 1 · see citing works
Adult ADHD in Depressive Disorders
Pallanti, S., & Salerno, L. (2020) · Springer eBooks · doi:10.1007/978-3-030-39051-8_10 · Cited by 1 · see citing works
ADHD Comorbidities with Depression, Anxiety, and Suicide
Sadek, J. R. (2016) · Springer eBooks · doi:10.1007/978-3-319-39794-8_4
When Bipolar Disorder Mimics ADHD
Baum, R., & Lindle, L. (2020) · Springer eBooks · doi:10.1007/978-3-030-62393-7_12
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Comorbidities and comedication among individuals in treatment for ADHD: a Danish nationwide study
Vestergaard, M., Hansen, R. F., Thomsen, P. H., Bentsen, A. H., & Falch-Joergensen, A. C. (2026) · BMC Psychiatry · doi:10.1186/s12888-026-07824-5
Similitudes et différences entre le TDAH et le TSA, illustrées par l’étude du défaut d’inhibition
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- Authors
- McIntyre, R. S., Kennedy, S. H., Soczynska, J. K., Nguyen, H. T. T., Bilkey, T. S., Woldeyohannes, H. O., Nathanson, J. A., Joshi, S., Cheng, J. S. H., Benson, K. M., & Muzina, D. J.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- McIntyre, Roger S.
- Venue
- The Primary Care Companion to The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2010-05-27
- Volume
- 12
- Issue
- 3
- ISSN
- 1523-5998 (ISSN-L)
- 1555-211X
- PMC
- PMC2947541
- OpenAlex
- W2060511695
- Cited by
- 103
- References
- 3
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 2 · 2023: 5 · 2022: 6 · 2021: 9 · 2020: 11 · 2019: 7 · 2018: 8 · 2017: 5 · 2016: 5 · 2015: 10 · 2014: 13 · 2013: 5 · 2012: 7
- FWCI
- 2.84
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Primary Care Companion to The Journal of Clinical Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- adult ADHD, bipolar disorder, major depressive disorder, comorbidities, age of onset, psychiatric comorbidity, quality of life, disease burden
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