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.’
