Clinical and diagnostic implications of lifetime attention-deficit/hyperactivity disorder comorbidity in adults with bipolar disorder: Data from the first 1000 STEP-BD participants
Clinical and diagnostic implications of lifetime attention-deficit/hyperactivity disorder comorbidity in adults with bipolar disorder: Data from the first 1000 STEP-BD participants
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DOI：
10.1016/j.biopsych.2005.01.036
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发表时间：
2005-06-01
影响因子：
10.6
通讯作者：
Sachs, GS
中科院分区：
文献类型：
--
作者：
Nierenberg, AA;Miyahara, S;Sachs, GS
背景资料：对诊断为双相情感障碍的儿童和青少年的系统研究表明，注意力缺陷/多动障碍（ADHD）的发病率在60%至90%之间，但ADHD在成人双相情感障碍患者中的患病率和影响尚不清楚。第一个连续1000名双相情感障碍成年人参加了国家精神卫生研究所的双相情感障碍系统治疗增强计划。对STEP-BD进行了终生ADHD评估。双相情感障碍的回顾过程。结果：在这个大的双相患者队列中，共病ADHD的总的终生患病率为9.5%（95%可信区间为7.6%-11.49%）; 14.7%的男性患者和5.8%的女性双相患者终生患有ADHD。患有双相情感障碍和ADHD的患者在大约5年前就开始出现情绪障碍。在调整了发病年龄后，那些患有ADHD合并症的人的健康时间更短，抑郁的频率更高。我们发现，与那些没有ADHD共病的患者相比，患有ADHD共病的双相情感障碍患者有更多的其他共病/精神病诊断，有更高的几种焦虑症、酒精和物质滥用和依赖的比率。终生多动症是双相情感障碍成人患者常见的共病，与双相情感障碍的恶化过程和其他精神共病的更大负担相关。需要研究关注ADHD与双相情感障碍共病的疗效和安全性。
Background: Systematic studies of children and adolescents with a diagnosis of bipolar disorder show that rates of attention-deficit/hyperactivity disorder (ADHD) range from 60% to 90%, but the prevalence and implications of ADHD in adults with bipolar disorder are less clear.Methods: The first consecutive 1000 adults with bipolar disorder enrolled in the National Institute of Mental Health's Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were assessed for lifetime ADHD. The retrospective course of bipolar disorder. current mood state, and prevalence of other comorbid psychiatric diagnoses were compared for the groups with and without lifetime comorbid ADHD.Results: The overall lifetime prevalence of comorbid ADHD in this large cohort of bipolar patients was 9.5% (95% confidence interval 7.6%-11.49%); 14.7% of male patients and 5.8% of female, patients with bipolar disorder had lifetime ADHD. Patients with bipolar disorder and ADHD bad the onset of their mood disorder approximately 5 years earlier. After adjusting for age of onset, those with ADHD comorbidity had shorter period of wellness and were more frequently depressed. We found that patients with bipolar disorder comorbid with ADHD had a greater number of other comorbic/psychiatric diagnoses compared with those without comorbid ADHD, with substantially higher rates of several anxiety disorders and alcohol and substance abuse and dependence.Conclusions: Lifetime ADHD is a frequent comorbid condition in adults with bipolar disorder, associated with a worse course of bpolar disorder and greater burden of other psychiatric comorbid conditions. Studies are needed that focus on the efficacy and safety of treating ADHD comorbid with bipolar disorder.