Anxiety, mood, and substance use disorders in adult men and women with and without attention-deficit/hyperactivity disorder: a substantive and methodological overview
Anxiety, mood, and substance use disorders in adult men and women with and without attention-deficit/hyperactivity disorder: a substantive and methodological overview
Knowledge on psychiatric comorbidity in adult ADHD is essential for prevention, detection, and treatment of these conditions. This review (1) focuses on large studies (n > 10,000; surveys, claims data, population registries) to identify (a) overall, (b) sex- and (c) age-specific patterns of comorbidity of anxiety disorders (ADs), major depressive disorder (MDD), bipolar disorder (BD) and substance use disorders (SUDs) in adults with ADHD relative to adults without ADHD; and (2) describes methodological challenges relating to establishing comorbidity in ADHD in adults as well as priorities for future research. Meta-analyses (ADHD: n = 550,748; no ADHD n = 14,546,814) yielded pooled odds ratios of 5.0(CI:3.29–7.46) for ADs, 4.5(CI:2.44–8.34) for MDD, 8.7(CI:5.47–13.89) for BD and 4.6(CI:2.72–7.80) for SUDs, indicating strong differences in adults with compared to adults without ADHD. Moderation by sex was not found: high comorbidity held for both men and women with sex-specific patterns as in the general population: higher prevalences of ADs, MDD and BD in women and a higher prevalence of SUDs in men. Insufficient data on different phases of the adult lifespan prevented conclusions on developmental changes in comorbidity. We discuss methodological challenges, knowledge gaps, and future research priorities.
Adults, Anxiety disorders, Attention-Deficit, Bipolar disorder, Comorbidity, Hyperactivity Disorder, Life course, Lifespan, Major depressive disorder, Sex differences, Substance use disorders, Attention-Deficit/Hyperactivity Disorder
Hartman, Catharina A.
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Larsson, Henrik
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Vos, Melissa
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Bellato, Alessio
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Libutzki, Berit
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Solberg, Berit Skretting
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Chen, Qi
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Du Rietz, Ebba
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Mostert, Jeanette C.
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Kittel-Schneider, Sarah
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Cormand, Bru
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Ribases, Marta
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Klungsoyr, Kari
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Haavik, Jan
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Dalsgaard, Soren
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Cortese, Samuele
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Faraone, Stephen V.
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Reif, Andreas
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August 2023
Hartman, Catharina A.
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Larsson, Henrik
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Vos, Melissa
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Bellato, Alessio
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Libutzki, Berit
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Solberg, Berit Skretting
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Chen, Qi
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Du Rietz, Ebba
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Mostert, Jeanette C.
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Kittel-Schneider, Sarah
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Cormand, Bru
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Ribases, Marta
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Klungsoyr, Kari
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Haavik, Jan
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Dalsgaard, Soren
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Cortese, Samuele
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Faraone, Stephen V.
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Reif, Andreas
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Hartman, Catharina A., Larsson, Henrik, Vos, Melissa, Bellato, Alessio, Libutzki, Berit, Solberg, Berit Skretting, Chen, Qi, Du Rietz, Ebba, Mostert, Jeanette C., Kittel-Schneider, Sarah, Cormand, Bru, Ribases, Marta, Klungsoyr, Kari, Haavik, Jan, Dalsgaard, Soren, Cortese, Samuele, Faraone, Stephen V. and Reif, Andreas
(2023)
Anxiety, mood, and substance use disorders in adult men and women with and without attention-deficit/hyperactivity disorder: a substantive and methodological overview.
Neuroscience and Biobehavioral Reviews, 151, [105209].
(doi:10.1016/j.neubiorev.2023.105209).
Abstract
Knowledge on psychiatric comorbidity in adult ADHD is essential for prevention, detection, and treatment of these conditions. This review (1) focuses on large studies (n > 10,000; surveys, claims data, population registries) to identify (a) overall, (b) sex- and (c) age-specific patterns of comorbidity of anxiety disorders (ADs), major depressive disorder (MDD), bipolar disorder (BD) and substance use disorders (SUDs) in adults with ADHD relative to adults without ADHD; and (2) describes methodological challenges relating to establishing comorbidity in ADHD in adults as well as priorities for future research. Meta-analyses (ADHD: n = 550,748; no ADHD n = 14,546,814) yielded pooled odds ratios of 5.0(CI:3.29–7.46) for ADs, 4.5(CI:2.44–8.34) for MDD, 8.7(CI:5.47–13.89) for BD and 4.6(CI:2.72–7.80) for SUDs, indicating strong differences in adults with compared to adults without ADHD. Moderation by sex was not found: high comorbidity held for both men and women with sex-specific patterns as in the general population: higher prevalences of ADs, MDD and BD in women and a higher prevalence of SUDs in men. Insufficient data on different phases of the adult lifespan prevented conclusions on developmental changes in comorbidity. We discuss methodological challenges, knowledge gaps, and future research priorities.
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Accepted/In Press date: 1 May 2023
e-pub ahead of print date: 5 May 2023
Published date: August 2023
Additional Information:
Funding Information:
This research has received funding from the EU's Horizon 2020 Research and Innovation Program under grant agreements 667302 (CoCA), 728018 (Eat2beNICE) and 965381(TIMESPAN) and from the 'ECNP network on ADHD across the lifespan'. BC was supported by the Spanish ‘Ministerio de Ciencia, Innovación y Universidades’ (PID2021-1277760B-I100), ‘Generalitat de Catalunya/AGAUR’ (2021-SGR-01093), ICREA Academia 2021, the European Union H2020 Program [H2020/2014-2020] under grant agreement 728018 (Eat2beNICE), ‘Fundació La Marató de TV3’ (202218-31) and the 'ECNP network of ADHD across the lifespan'. SF's research is supported by NIMH grants U01MH109536-01, U01AR076092-01A1, R0MH116037 and 5R01AG06495502.
Funding Information:
This research has received funding from the EU’s Horizon 2020 Research and Innovation Program under grant agreements 667302 (CoCA), 728018 (Eat2beNICE) and 965381 (TIMESPAN) and from the 'ECNP network on ADHD across the lifespan'. BC was supported by the Spanish ‘Ministerio de Ciencia , Innovación y Universidades’ ( PID2021-1277760B-I100 ), ‘ Generalitat de Catalunya/AGAUR ’ ( 2021-SGR-01093 ), ICREA Academia 2021, the European Union H2020 Program [ H2020/2014-2020 ] under grant agreement 728018 (Eat2beNICE), ‘ Fundació La Marató de TV3 ’ ( 202218-31 ) and the 'ECNP network of ADHD across the lifespan'. SF’s research is supported by NIMH grants U01MH109536-01 , U01AR076092-01A1 , R0MH116037 and 5R01AG06495502 .
Publisher Copyright:
© 2023
Keywords:
Adults, Anxiety disorders, Attention-Deficit, Bipolar disorder, Comorbidity, Hyperactivity Disorder, Life course, Lifespan, Major depressive disorder, Sex differences, Substance use disorders, Attention-Deficit/Hyperactivity Disorder
Identifiers
Local EPrints ID: 482003
URI: http://eprints.soton.ac.uk/id/eprint/482003
ISSN: 0149-7634
PURE UUID: 5e151557-4a4a-4248-ad94-f0801c39b9fe
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Date deposited: 15 Sep 2023 16:30
Last modified: 18 Mar 2024 04:16
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Contributors
Author:
Catharina A. Hartman
Author:
Henrik Larsson
Author:
Melissa Vos
Author:
Alessio Bellato
Author:
Berit Libutzki
Author:
Berit Skretting Solberg
Author:
Qi Chen
Author:
Ebba Du Rietz
Author:
Jeanette C. Mostert
Author:
Sarah Kittel-Schneider
Author:
Bru Cormand
Author:
Marta Ribases
Author:
Kari Klungsoyr
Author:
Jan Haavik
Author:
Soren Dalsgaard
Author:
Stephen V. Faraone
Author:
Andreas Reif
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