Anxiety, mood, and substance use disorders in adult men and women with and without attention-deficit/hyperactivity disorder: A substantive and methodological overview

Catharina A Hartman*, Henrik Larsson, Melissa Vos, Alessio Bellato, Berit Libutzki, Berit Skretting Solberg, Qi Chen, Ebba Du Rietz, Jeanette C Mostert, Sarah Kittel-Schneider, Bru Cormand, Marta Ribasés, Kari Klungsøyr, Jan Haavik, Søren Dalsgaard, Samuele Cortese, Stephen V Faraone, Andreas Reif

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

19 Citations (Scopus)
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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.

Original languageEnglish
Article number105209
Number of pages18
JournalNeuroscience and Biobehavioral Reviews
Volume151
DOIs
Publication statusPublished - Aug-2023

Keywords

  • Adult
  • Female
  • Humans
  • Male
  • Anxiety/epidemiology
  • Anxiety Disorders/epidemiology
  • Attention Deficit Disorder with Hyperactivity/epidemiology
  • Comorbidity
  • Depressive Disorder, Major/epidemiology
  • Substance-Related Disorders/epidemiology

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