Abstract
AbstractBackgroundDepression is highly heterogeneous in its clinical presentation. Those with attention deficit/hyperactivity disorder (ADHD) may be at risk of a more chronic and impairing depression compared to those with depression alone according to studies of young people. However, no studies to date have examined ADHD in recurrently depressed adults in mid-life.AimsTo investigate ADHD in women in mid-life with a history of recurrent depression.MethodIn a sample of women in mid-life (n=148) taken from a UK based prospective cohort of adults with a history of recurrent depression, we investigated the prevalence of ADHD and the association of ADHD with clinical features of depression.Results12.8% of the recurrently depressed women had elevated ADHD symptoms and 3.4% met DSM-5 diagnostic criteria for ADHD. None of the women reported having a diagnosis of ADHD from a medical professional. ADHD was associated with earlier age of depression onset, higher depression associated impairment, a greater recurrence of depressive episodes and increased persistence of subthreshold depression symptoms over the study period, higher levels of irritability and increased risk of self-harm or suicide attempt. ADHD symptoms were associated with increased risk of hospitalisation and receiving non-first line antidepressant medication.ConclusionsHigher ADHD symptoms appear to index a worse clinical presentation for depression. Findings suggest that in women with early onset, impairing and recurrent depression, the possibility of underlying ADHD masked by depression needs to be considered.
Publisher
Cold Spring Harbor Laboratory
Reference40 articles.
1. Depression is not a consistent syndrome: an investigation of unique symptom patterns in the STAR*D study;J Affect Disord [Internet],2015
2. The identification and validation of distinct depressive syndromes in a population-based sample of female twins;Arch Gen Psychiatry [Internet],1996
3. Understanding the Clinical Heterogeneity of Major Depression Using Family Data
4. Riglin L , Leppert B , Dardani C , Thapar AK , Rice F , O’Donovan MC , et al. ADHD and depression: investigating a causal explanation. Psychol Med [Internet]. 2020/04/06. 2020;1–8. Available from: https://www.cambridge.org/core/article/adhd-and-depression-investigating-a-causal-explanation/02FC95F0E26F6265C7024856227DC510
5. New insights into the comorbidity between ADHD and major depression in adolescent and young adult females;J Am Acad Child Adolesc Psychiatry [Internet],2008