ADHD and Comorbidities

 The most common psychiatric disorders comorbid with ADHD in adults are:

·       Anxiety

·       Personality disorders

·       Learning disabilities

·       Mood disorders

·       Substance use disorders

    • There is a 25% comorbidity rate for ADHD & Anxiety.  Adults with both ADHD and Anxiety may experience sleep problems.  It may be that adults with both Anxiety and ADHD may not respond as well as expected to interventions such as cognitive behavioural therapy (D’Agati, Curatolo & Mazzone 2019)

    • Research has suggested that for adults with both Anxiety and ADHD there pay be poorer levels of educational attainment (Quenneville et al 2022) – though it is unclear whether this is due to poor management.

    • There is evidence to suggest that people with both ADHD & Anxiety are also likely to have a more profound clinical presentation, including higher risks of psychosis, suicidal thoughts and risk of hospitalisation for these; as well as a higher disposition towards anger (Quenneville et al 2022).

    • Adults with ADHD & Generalised Anxiety Disorder can face difficulties with social relationships which can significantly impact quality of life and social functioning (Fuller-Thomson, Carrique & MacNeil 2022).

    • Although research is limited, studies have shown that there is an increased prevalence of Diabetes in people with ADHD and vice versa (Ai, Zhao, Liu, Li & Zhu 2022).

    • The reason for this association remains unclear however recent research has suggested that having type 1 diabetes or maternal pregestational diabetes increased the risk of having a child with ADHD (Ai, Zhao, Liu, Li & Zhu 2022).

    • Having ADHD is likely to make it harder for people to manage their diabetes, due to the need for planning, prioritising and routine to manage the condition.  This in turn can increase the risk of Diabetic Ketoacidosis (Vinker-Shuster et al, 2022).

    • Appropriate management of the symptoms of ADHD has been shown to improve glycaemic control in people with both ADHD and Type 1 Diabetes (Dehnavi et al, 2024).

    • Rates of Bipolar disorder in Adults with ADHD very significantly from as little as 5% to 47% (Martz, Weibel & Weiner 2022).  With some placing this at 20% (Salvi et al 2021).

    • There are some shared symptoms including hyperactivity, impulsivity and inattention (Salvi et al 2021).

    • It is thought that between 45 and 55% of adults with ADHD also have depression (Salvi et al, 2021).

    • Having ADHD can increase the burden of having Depression (Kessler et al, 2006).

    • It is thought that the impairments associated with having ADHD can lead to the onset of depression (Mao & Findling, 2014).

Helpful Research:

Kooij JJS, Bijlenga D, Salerno L et al.. Updated European consensus statement on diagnosis and treatment of adult ADHD. Eur Psychiatry. 2019;56:14–34 https://doi.org/10.1016/j.eurpsy.2018.11.001 Crossref, Medline, Google Scholar

D’Agati, E., Curatolo, P., & Mazzone, L. (2019). Comorbidity between ADHD and anxiety disorders across the lifespan. International Journal of Psychiatry in Clinical Practice, 23(4), 238-244.

Quenneville, A. F., Kalogeropoulou, E., Nicastro, R., Weibel, S., Chanut, F., & Perroud, N. (2022). Anxiety disorders in adult ADHD: A frequent comorbidity and a risk factor for externalizing problems. Psychiatry research, 310, 114423.

Fuller-Thomson, E., Carrique, L., & MacNeil, A. (2022). Generalized anxiety disorder among adults with attention deficit hyperactivity disorder. Journal of affective disorders, 299, 707-714.

Ai, Y., Zhao, J., Liu, H., Li, J., & Zhu, T. (2022). The relationship between diabetes mellitus and attention deficit hyperactivity disorder: A systematic review and meta-analysis. Frontiers in pediatrics, 10, 936813.

Vinker-Shuster, M., Eldor, R., Green, I., Golan-Cohen, A., Manor, I., & Merzon, E. (2022). Glycemic control and diabetes related complications in adults with type 1 diabetes mellitus and ADHD. Journal of attention disorders, 26(9), 1235-1244.

Dehnavi, A. Z., Elmitwalli, I., Alsharif, H. O., Razavi, A. S., Gumpel, T. A., Smith, A., ... & Zhang-James, Y. (2024). Effects of ADHD and ADHD treatment on glycemic management in type 1 diabetes: A systematic review and meta-analysis of observational studies. Diabetes Research and Clinical Practice, 209, 111566.

Salvi, V., Ribuoli, E., Servasi, M., Orsolini, L., & Volpe, U. (2021). ADHD and bipolar disorder in adulthood: Clinical and treatment implications. Medicina, 57(5), 466.

Martz, E., Weibel, S., & Weiner, L. (2022). An overactive mind: Investigating racing thoughts in ADHD, hypomania and comorbid ADHD and bipolar disorder via verbal fluency tasks. Journal of Affective Disorders, 300, 226-234.

Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O., ... & Zaslavsky, A. M. (2006). The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. American Journal of psychiatry, 163(4), 716-723.

Mao, A. R., & Findling, R. L. (2014). Comorbidities in adult attention-deficit/hyperactivity disorder: a practical guide to diagnosis in primary care. Postgraduate medicine, 126(5), 42-51.