Prevalence of attention-deficit/hyperactivity disorder in people with mood disorders: A systematic review and meta-analysis.

Sandstrom, Andrea; Perroud, Nader; Alda, Martin; Uher, Rudolf; Pavlova, Barbara

OBJECTIVE Attention-deficit/hyperactivity disorder (ADHD) in mood disorders is associated with unfavourable outcomes, including more frequent mood episodes, and increased risk of suicide. The reported prevalence of ADHD in individuals with mood disorders varies widely. METHODS We searched PsycInfo, and PubMed for articles published before September 21st , 2020 using search terms for ADHD and mood disorders. We included original data on the prevalence of ADHD in individuals with bipolar disorder (BD) or major depressive disorder (MDD). We estimated the prevalence of ADHD, by developmental period and disorder using random-effect meta-analyses. We also compared the rate of ADHD in people with MDD and BD, and with and without mood disorders. RESULTS Based on 92 studies including 17089 individuals, prevalence of ADHD in BD is 73% (95% CI 66-79) in childhood, 43% (95% CI 35-50) in adolescence, and 17% (95% CI 14-20) in adulthood. Data from 52 studies with 16897 individuals indicated that prevalence of ADHD in MDD is 28% (95% CI 19-39) in childhood, 17% (95% CI 12-24) in adolescence, and 7% (95% CI 4-11) in adulthood. ADHD was three times more common in people with mood disorders compared to those without, and 1.7 times more common in BD compared to MDD. CONCLUSION People with mood disorders are at a significant risk for ADHD. ADHD should be assessed and treated in individuals with BD and MDD. Comprehensive assessment strategies are needed to address challenges of diagnosing ADHD alongside mood disorders.