Prevalence of Attention Deficit Hyperactivity Disorder in Adult Patients With Fibromyalgia

To determine the prevalence of attention deficit hyperactivity disorder (ADHD) in patients with fibromyalgia (FM) without a prior diagnosis of ADHD, compared with the general population, and to assess its relationship with FM impact.

A cross-sectional study was conducted in adults diagnosed with FM (ACR 2016 criteria) without known cognitive impairment, compared with age-matched, sex-matched, and education-matched controls. Participants completed the Fibromyalgia Impact Questionnaire (FIQ-R), the Argentine version of the Health Assessment Questionnaire (HAQ-A), the Montreal Cognitive Assessment (MoCA) for cognitive impairment, the Conners Continuous Performance Test II (CPT II) for adult ADHD, and the Wender-Utah Rating Scale (WURS) for retrospective childhood ADHD symptoms. Cognitive and neuropsychological tests were performed by specialized staff from the neurology service. Statistical analysis included univariate tests and multivariate logistic regression.

Sixty FM patients and 71 controls were included. Adult ADHD was present in 61.7% of FM patients, with 48.6% undiagnosed in childhood. ADHD presence was not associated with higher FIQ-R or HAQ-A scores. Childhood ADHD symptoms were significantly associated with adult ADHD (OR: 62.3; p =0.003). FM patients had a higher prevalence of cognitive impairment (43.3% vs. 16.9%), childhood ADHD symptoms (31.7% vs. 14.1%), and adult ADHD (61.7% vs. 23.9%) compared with controls.

Adult ADHD was highly prevalent in FM patients and often missed in childhood. Its presence was associated with prior childhood symptoms but not with greater disease impact or functional disability. FM patients also showed increased cognitive impairment and ADHD symptoms compared with the general population.