Attention deficit hyperactivity disorder and bipolar disorder: comorbidities and psychosocial impairment

Abstract

Background and aims:

This study aims to compare ADHD and Bipolar Disorder(BPD) regarding comorbid axis I psychiatric disorders, personality disorders, existence of general psychopathology as measured on SCL-90-R and in areas of educational attainment and psychosocial adjustment.

Method:

38 patients who were diagnosed with ADHD in Marmara University Hospital, Psychiatry Department Adult ADHD Outpatient Clinic and 38 patients receiving treatment for Bipolar Disorder in Mood Disorders outpatient clinic during the same period, have been included in the study. The socio-demographic characterization was done using a semi-structured interview. To evaluate the presence of psychiatric comorbidity, structured clinical interviews (SCID-I and II) were conducted by two general psychiatrists experienced in ADHD and trained in SCID administration. All groups were given SCL-90-R for general psychopathology assessment and BDI for depression assessment.

Results:

The ADHD and BPD patients did not differ in terms of marital status, the number of suicide attempts and family psychiatric history. However, ADHD patients had significantly greater scores on SCL-90 general psychopathology scale (F(1,66)=27.303, p<.001) and higher scores on depressive symptomatology (F(1,63)= 10.988, p<.005). ADHD patients had comparable frequency of comorbid axis I disorder and significantly higher frequency of comorbid axis II personality disorders (F(1,64)= 24.438, p<.001). Besides, repeating educational years (F(1,66)=7.447, p<.005) were more likely to be seen in ADHD patients in contrast to BPD patients.

Conclusion:

ADHD is a disorder that affects, no less significantly than BPD, educational achievement, and psychiatric comorbidity, especially in terms of increased presence of axis II disorders and psychiatric symptoms.