Individuals with bipolar disorder (BD) and major depressive disorder (MDD) were at increased risk for comorbid attention deficit hyperactivity disorder (ADHD) throughout life, according to results from a systematic review and meta-analysis published in Acta Psychiatrica Scandinavica.

Researchers from Dalhousie University in Canada searched publication databases through September of 2020 for articles on ADHD, attention deficit disorder (ADD), BD, and affective psychosis.

A total of 127 articles comprising 33,986 patients with ADHD and BD (n=17,089) or MDD (n=16,897) were included in this analysis.

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Among patients with BD, 73% (95% CI, 66%-79%) were diagnosed with comorbid ADHD in childhood, 43% (95% CI, 35%-50%) in adolescence, and 17% (95% CI, 14%-20%) in adulthood (range I2, 90.00%-93.20%).

Stratified by age of ADHD diagnosis, Diagnostic and Statistical Manual (DSM) version (b, -1.10; 95% CI, -2.02 to -0.18; P =.022), age (b, -0.49; 95% CI, -0.76 to -0.21; P =.001), and gender (b, 0.05; 95% CI, 0.01-0.09; P =.021) were significant predictors of ADHD during childhood and among adolescents, ADHD associated with geographical location (b, -0.97; 95% CI, -1.69 to -0.25; P =.01).

Among patients with MDD, 28% (95% CI, 19%-39%) were diagnosed with comorbid ADHD in childhood, 17% (95%, CI, 12%-24%) in adolescence, and 7% (95% CI, 4%-11%) in adulthood (range, I2, 91.10%-96.50%).

Stratified by age of ADHD diagnosis, age (b, -0.06; 95% CI, -0.12 to -0.003; P =.04) was a significant predictor of ADHD among adults.

Comparing studies, ADHD was more prevalent among patients with BD (risk ratio [RR], 1.72; 95% CI, 1.20-2.47; P =.003; I2, 82.80%) compared with MDD. Among the 15 studies that included data on healthy controls, patients with mood disorders were at increased risk for ADHD (RR, 3.42; 95% CI, 2.81-4.16; P <.001; I2, 59.70%).

This study was limited by the high heterogeneity that was observed among the underlying studies.

These findings indicated that individuals with mood disorders were at increased risk for comorbid ADHD, indicating patients with BD or MDD may require additional screening for ADHD to ensure adequate and effective treatment.

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Sandstrom A, Perroud N, Alda M, Uher R, Pavlova B. Prevalence of attention-deficit/hyperactivity disorder in people with mood disorders: A systematic review and meta-analysis. Acta Psychiatr Scand. Published online February 2, 2021. doi:10.1111/acps.13283

This article originally appeared on Psychiatry Advisor