Adult attention-deficit/hyperactivity disorder and bipolar disorder: diagnostic and management challenges
Introduction Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) are neurodevelopmental disorders that commonly persist into adulthood. ADHD in adults can resemble, and often co-occurs with, bipolar disorder (BD), which might lead to diagnostic errors, ineffective treatment an...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822011853/type/journal_article |
| _version_ | 1827754959465086976 |
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| author | M. Barbosa R. Guedes |
| author_facet | M. Barbosa R. Guedes |
| author_sort | M. Barbosa |
| collection | DOAJ |
| description |
Introduction
Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) are neurodevelopmental disorders that commonly persist into adulthood. ADHD in adults can resemble, and often co-occurs with, bipolar disorder (BD), which might lead to diagnostic errors, ineffective treatment and potentially serious adverse consequences.
Objectives
To review on the overlaps and differences in the psychopathology of the two entities and particularities of the management when they occur comorbidely.
Methods
The Medline database through the Pubmed search engine was used with the following keywords: “adhd” and “bipolar disorder”.
Results
ADHD has an estimated prevalence of 10-30% in adults with BD. Despite the symptomatic similarities, there are some important differences. In the ADHD/BD comorbidity, symptoms like attention-deficit, distractibility, irritability, impulsiveness and hyperactivity that may present in (hypo)manic and/or depressive episodes, tend to persist after clinical stabilization. While adult patients with ADHD typically experience ceaseless mental activity and wandering mind, BD patients may have racing thoughts and perceive them as making sense. ADHD patients may have poor socio-occupational achievement that may lead to low self-esteem, low self-confidence and depressed mood. Features like course of illness, psychiatric family history and treatment response may help differentiate the two entities. The treatment must start with mood stabilization and then proceed to the treatment of ADHD symptoms.
Conclusions
A complete clinical history, with particular focus in the neurodevelopmental history, is important but sometimes is not enough for an accurate diagnosis of this comorbidity. As so, clinicians should be aware of the high comorbidity rates to prevent misdiagnosis and provide the best care for both disorders.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:56:52Z |
| format | Article |
| id | doaj.art-80ec8748a10b45c6a7f75ca988013803 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:56:52Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-80ec8748a10b45c6a7f75ca9880138032023-11-17T05:05:26ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S466S46710.1192/j.eurpsy.2022.1185Adult attention-deficit/hyperactivity disorder and bipolar disorder: diagnostic and management challengesM. Barbosa0R. Guedes1Centro Hospitalar de Leiria, Department Of Mental Health And Psychiatry, Leiria, PortugalCentro Hospitalar de Leiria, Department Of Mental Health And Psychiatry, Leiria, Portugal Introduction Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) are neurodevelopmental disorders that commonly persist into adulthood. ADHD in adults can resemble, and often co-occurs with, bipolar disorder (BD), which might lead to diagnostic errors, ineffective treatment and potentially serious adverse consequences. Objectives To review on the overlaps and differences in the psychopathology of the two entities and particularities of the management when they occur comorbidely. Methods The Medline database through the Pubmed search engine was used with the following keywords: “adhd” and “bipolar disorder”. Results ADHD has an estimated prevalence of 10-30% in adults with BD. Despite the symptomatic similarities, there are some important differences. In the ADHD/BD comorbidity, symptoms like attention-deficit, distractibility, irritability, impulsiveness and hyperactivity that may present in (hypo)manic and/or depressive episodes, tend to persist after clinical stabilization. While adult patients with ADHD typically experience ceaseless mental activity and wandering mind, BD patients may have racing thoughts and perceive them as making sense. ADHD patients may have poor socio-occupational achievement that may lead to low self-esteem, low self-confidence and depressed mood. Features like course of illness, psychiatric family history and treatment response may help differentiate the two entities. The treatment must start with mood stabilization and then proceed to the treatment of ADHD symptoms. Conclusions A complete clinical history, with particular focus in the neurodevelopmental history, is important but sometimes is not enough for an accurate diagnosis of this comorbidity. As so, clinicians should be aware of the high comorbidity rates to prevent misdiagnosis and provide the best care for both disorders. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822011853/type/journal_articlebipolar disorderadhd |
| spellingShingle | M. Barbosa R. Guedes Adult attention-deficit/hyperactivity disorder and bipolar disorder: diagnostic and management challenges European Psychiatry bipolar disorder adhd |
| title | Adult attention-deficit/hyperactivity disorder and bipolar disorder: diagnostic and management challenges |
| title_full | Adult attention-deficit/hyperactivity disorder and bipolar disorder: diagnostic and management challenges |
| title_fullStr | Adult attention-deficit/hyperactivity disorder and bipolar disorder: diagnostic and management challenges |
| title_full_unstemmed | Adult attention-deficit/hyperactivity disorder and bipolar disorder: diagnostic and management challenges |
| title_short | Adult attention-deficit/hyperactivity disorder and bipolar disorder: diagnostic and management challenges |
| title_sort | adult attention deficit hyperactivity disorder and bipolar disorder diagnostic and management challenges |
| topic | bipolar disorder adhd |
| url | https://www.cambridge.org/core/product/identifier/S0924933822011853/type/journal_article |
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