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Check depressed patients for ADHD symptoms, study suggests

Clinicians treating patients with major depression should consider whether they suffer from underlying, undiagnosed ADHD, a study has suggested.

Using data from self-reported questionnaires from over 2,000 patients, researchers found that patients with current depression were four-and-a-half times more likely to have probable ADHD than patients not currently depressed or without a history of depression.

The study, published in the Journal of Affective Disorders, also found that the more severe the depression, the more likely the patient was to have underlying, undiagnosed ADHD.

Patients with mild depression had a greater than two-fold increase in risk of having ADHD symptoms, while those with moderate and severe had an eight- and six-fold increase, respectively, when compared to non-depressed patients.

The paper said: ‘Persons with severe, persistent, un-remitting and chronic depression have a 7.5-fold increased prevalence of clinical ADHD symptoms when compared to general population estimates of ADHD.

'Because of the low response rates reported in treatment-resistant depression, considering comorbid lifetime ADHD symptoms may be an important factor for possible improvement of the treatment of chronic depression.’

The researchers, who focused on symptoms including sensation-seeking, mood instability and distractibility, studied 2,053 participants in the ongoing Netherlands Study of Depression and Anxiety between the ages of 21 and 69, with data from the four-year follow-up assessment used to ascertain depressive status and ADHD symptoms.

They found that despite the high prevalence of ADHD symptoms among depressed patients, only 5% of adults with probable ADHD were using stimulants – the recommended drug treatment for ADHD, concluding that clinicians therefore needed to pay more attention to possible ADHD in depressed patients.

The paper said: ‘Low levels of stimulant use may suggest that ADHD symptoms are overlooked in depression, due to referral for depressive disorders instead of undiagnosed ADHD. Therefore, ADHD symptomology deserves more attention in depressed individuals, as treatment of comorbid ADHD symptoms may also impact the outcome and course of the depressive episode.'


Readers' comments (4)

  • "only 5% of adults with probable ADHD were using stimulants – the recommended drug treatment for ADHD, concluding that clinicians therefore needed to pay more attention to possible ADHD in depressed patients."

    Oh give my strength!!! We we have any patients not swallowing a psychotropic?

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  • Please may we routinely have access to all information on Pharmaceutical Corporate Financial Incentives, and Author's Financial Conflicts of Interests - (if any) - in all "research" alleging "under-diagnosis" of "psychiatric co-morbidity" or in reality "co-labelling".
    This is especially important when one or more "medications" with frequently missed and / or ignored, serious ADR's has "revealed" a previously "latent mental illness"!
    Although all "medications" used in "Major Depressive Disorder" can produce psychological, behavioural as well as physical toxicities", (and behavioural and psychological acute, sub-acute and chronic features in withdrawal syndromes) -- these are far more likely to be labelled as additional SMI's and/ or "proof" that more toxic and injurious (?lucrative?) drugging is required.
    It is getting hard to afford endless "pharma-focused" reports any clinically relevant credibility at all.
    Genuinely unbiased research has to be recognised as such. Perhaps this is, but how can we know?
    The increasing reports alleging manipulated clinical trials and scientific misconduct mandate the availability of all relevant information.

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  • 'ADHD' is not a medical problem.

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  • I am not sure why some one feels ADHD is not medical. ? When saying medical so you mean psychiatric problems also are encompassed in your belief. ? Neuro - developmental. ? Learning disability ? It does not matter where you place it. It's " medical ". Believe me. ADHD is not a case of "naughty unruly children". Who just need " stricter parenting and boundaries to be enforced " In actual fact many ADHD children are not naughty or unruly. . They genuinely can't focus. All the tea in China can't make them. Also as regards the validity of clinical trials why is there all this pharmaceutical company bashing ? They abide by the normal rules re patents. Many mental health drugs now cost very little. These drugs have helped enormously. How about going back to the Victorian era and chaining up these people. Or look at Indonesia. No one gets drugs or help. They end up shackled to wooden poles to stop them creating havoc. At a time when medical school has such an emphasis on social and psychological cultural teaching people still come up with this anti mental health rhetoric !!!

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