Comorbidity of ADHD and adult bipolar disorder: A systematic review and meta-analysis

  • Carmen Schiweck
  • , Gara Arteaga-Henriquez
  • , Mareike Aichholzer
  • , Sharmili Edwin Thanarajah
  • , Sebastian Vargas-Cáceres
  • , Silke Matura
  • , Oliver Grimm
  • , Jan Haavik
  • , Sarah Kittel-Schneider
  • , Josep Antoni Ramos-Quiroga
  • , Stephen V. Faraone
  • , Andreas Reif

Research output: Contribution to journalReview articlepeer-review

Abstract

Attention-deficit / hyperactivity disorder (ADHD) and Bipolar Disorder (BD) are common mental disorders with a high degree of comorbidity. However, no systematic review with meta-analysis has aimed to quantify the degree of comorbidity between both disorders. To this end we performed a systematic search of the literature in October 2020. In a meta-analysis of 71 studies with 646,766 participants from 18 countries, it was found that about one in thirteen adults with ADHD was also diagnosed with BD (7.95 %; 95 % CI: 5.31–11.06), and nearly one in six adults with BD had ADHD (17.11 %; 95 % CI: 13.05–21.59 %). Substantial heterogeneity of comorbidity rates was present, highlighting the importance of contextual factors: Heterogeneity could partially be explained by diagnostic system, sample size and geographical location. Age of BD onset occurred earlier in patients with comorbid ADHD (3.96 years; 95 % CI: 2.65–5.26, p < 0.001). Cultural and methodological differences deserve attention for evaluating diagnostic criteria and clinicians should be aware of the high comorbidity rates to prevent misdiagnosis and provide optimal care for both disorders.

Original languageEnglish
Pages (from-to)100-123
Number of pages24
JournalNeuroscience and Biobehavioral Reviews
Volume124
DOIs
Publication statusPublished - May 2021
Externally publishedYes

Keywords

  • ADHD
  • Adult bipolar disorder
  • Age of onset
  • Attention deficit hyperactivity disorder
  • Comorbidity
  • Prevalence

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