Bipolar disorder comorbid with attention-deficit/hyperactivity disorder in adult inpatients with acute relapse

The aim of this prospective, observational study was to detect the rate of comorbid attention-deficit/hyperactivity disorder (ADHD) in a sample of inpatients diagnosed with bipolar disorder, and to identify differences between patients with bipolar disorder with concomitant ADHD and those without concomitant ADHD.

Fifty subjects with bipolar disorder (DSM-IV-TR criteria) aged 18 to 65 years were enrolled in the study in Kingston, Ontario, from October 2008 to April 2010, following their admission to an adult inpatient psychiatric unit during an acute relapse. The Mini-International Neuropsychiatric Interview (MINI) and the ADHD Rating Scale were used to screen the subjects for ADHD and bipolar disorder, while the Hamilton Depression Rating Scale, the Young Mania Rating Scale, and the Global Assessment of Function were used to assess clinical severity at baseline and at 8 weeks.

Thirteen (26%) of the enrolled patients rated positive for ADHD on both the MINI and the ADHD Rating Scale. At baseline, no differences were found between the patients with ADHD and those without ADHD with regard to gender, age, length of hospitalization, and severity of clinical and functional deterioration. At 8 weeks, patients with ADHD had lower general scores for depression (P = .025) than those without ADHD.

In a psychiatric inpatient sample, patients with bipolar disorder and ADHD were not more severely ill in the acute phase and did not have a poorer outcome at 8 weeks.