Patients With Comorbid ADHD, Bipolar Disorder More Susceptible to Other Disorders

Patients with comorbid bipolar disorder and attention-deficit hyperactivity disorder (ADHD) were found to have higher odds of other comorbid disorders, according to a new study published in the Australian & New Zealand Journal of Psychiatry.

“Comorbid bipolar disorder/attention-deficit hyperactivity disorder may have some distinctive clinical features including an earlier onset of bipolar disorder and higher comorbid alcohol/substance use disorder rates,” lead author Francesco Bartoli, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy, and co-authors noted. “Further research is needed to identify additional clinical characteristics of this comorbidity.”

Related: In which gender is ADHD more prevalent?

Researchers examined 43 studies occurring before June 2021 and performed random-effects meta-analyses with relevant meta-regression and quality-based sensitivity analyses to examine the connection and find the most common correlations between ADHD and bipolar disorder. 

ADHD patients were more likely to be male (odds ratio = 1.46; p < 0.001), unemployed (odds ratio = 1.45; p = 0.045), and single (odds ratio = 0.62; p = 0.014). They were also more likely to have an earlier onset of bipolar disorder (standardized mean difference = -0.36; p < 0.001), more mood episodes (standardized mean difference = 0.35; p = 0.007) as well as higher odds of using antidepressants (odds ratio = 1.80; p = 0.024) and attempting suicide (odds ratio = 1.83; p < 0.001).

Patients were also more likely to have certain other comorbid conditions such as:
•    generalized anxiety disorder (odds ratio = 1.50; p = 0.019) 
•    panic disorder (odds ratio = 1.89; p < 0.001) 
•    social phobia (odds ratio = 1.61; p = 0.017) 
•    eating disorders (odds ratio = 1.91; p = 0.007) 
•    antisocial personality disorder (odds ratio = 3.59; p = 0.004) 
•    substance use disorders (odds ratio = 2.29; p < 0.001)  
•    alcohol use disorders (odds ratio = 2.28; p < 0.001)

Reference
Bartoli F, Callovini T, Cavaleri D, et al. Clinical correlates of comorbid attention deficit hyperactivity disorder in adults suffering from bipolar disorder: A meta-analysis. Aust N Z J Psychiatry. 2023;57(1):34-48. doi: 10.1177/00048674221106669.