Adults with ADHD often have other mental disorders

Adults with a history of Attention Deficit Hyperactivity Disorder (ADHD) often suffer from multiple psychiatric problems during their lives including Depression, anxiety and substance use, according to a study.

Researchers found that in a group of parents with past or current ADHD symptoms, 87 percent also had at least one other psychiatric disorder over their lives, while 56 percent had two or more. Major depression was the most common diagnosis, affecting 59 percent of the group.

That the estimated 4 percent of adults with ADHD may have such high rates of co-existing disorders stands as a “major public health problem,” the authors of the study maintain in the American Journal of Psychiatry.

One of the concerns, they note, is that these disorders can affect parenting. In this study, all of the participants were parents of children with ADHD, which is believed to have a strong genetic component.

Dr. James J. McGough and his colleagues at the University of California, Los Angeles, assessed 435 parents who had at least one child diagnosed with definite ADHD and another with “probable” or definite ADHD.

Through standard questionnaires and interviews, the researchers found that 35 percent of parents had ADHD at some point in their lives—with about half still showing symptoms.

Moreover, compared with parents with no lifetime ADHD symptoms, these parents had higher risks-and in some cases, earlier onset-of a number of psychiatric disorders.

People with ADHD may show the following signs of inattention:
# being easily distracted by sights, sounds, and other stimuli
# losing or forgetting tools and materials needed for a job
# making careless mistakes because of poor attention to details

Someone who has ADHD may also show signs of impulsivity and hyperactivity, such as:
# feeling restless much of the time
# fidgeting or squirming
# having trouble waiting in line
# interrupting while another person is speaking
# moving around when quiet behavior is expected

For example, 21 percent of ADHD-affected parents had an anxiety disorder at some point, versus 8 percent of unaffected parents. Fifty-nine percent of the ADHD group suffered from major depression during their lives, compared with 40 percent of unaffected parents.

Two childhood behavioral problems, oppositional defiant disorder and conduct disorder, were also far more common among parents with a history of ADHD. In addition, both of these disorders, as well as major depression, tended to arise at a younger age among ADHD-affected parents.

It’s unclear, according to McGough’s team, whether these co-existing disorders emerge as a consequence of ADHD, or represent some biological susceptibility to certain psychiatric conditions.

For now, they suggest that doctors look for signs of other psychiatric conditions when assessing adult ADHD, and consider the possibility of the attention disorder when evaluating adults for conditions like depression and anxiety.

High rates of co-existing mental health conditions are more than a matter of “personal suffering,” as parenting abilities may suffer as well, according to an editorial published with the report.

“The study lays bare the large extent to which ADHD is a family affair,” writes Dr. Andres Martin of Yale University in New Haven, Connecticut.

SOURCE: American Journal of Psychiatry, September 2005.

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