Neuropsychological profiles of adult bipolar disorder patients with and without comorbid attention-deficit hyperactivity disorder

Sara Salarvan,Caitlin Clements,Mikael Landén,Eleonore Rydén,Timea Sparding

doi:10.1186/s40345-019-0149-9

Abstract

BackgroundComorbid attention-deficit/hyperactivity disorder (ADHD) is common in bipolar disorder and associated with worse outcomes. Cognitive testing might be a tool to identify this group. Here we compare the neuropsychological profiles of bipolar disorder patients with (BD + cADHD) and without (BD − cADHD) childhood attention-deficit hyperactivity disorder.MethodsAdult patients with BD − cADHD (n = 66), BD + cADHD (n = 32), and healthy controls (n = 112) were tested using a comprehensive battery of neuropsychological tests. Patients underwent rigorous diagnostic assessments for bipolar disorder and ADHD, as well as a parental interview to establish childhood ADHD.ResultsThe neuropsychological profiles of the groups were similar, except that the BD + cADHD group performed significantly worse on working memory. Working memory did not differ between those in the BD + cADHD group who only had a history of childhood ADHD and those that still met criteria for ADHD in adulthood.ConclusionsCognitive testing had limited power to differentiate between bipolar disorder adults with and without childhood ADHD. The BD + cADHD subgroup cannot explain the significant cognitive heterogeneity seen in bipolar disorder patients.

Highlights

IntroductionThe prevalence of comorbid attention-deficit/hyperactivity disorder (ADHD) in adults with bipolar disorder (BD) ranges between 9.5 and 28% (Nierenberg et al 2005; Rydén et al 2009; Torres et al 2015)
The prevalence of comorbid psychiatric diagnoses other than attention-deficit/hyperactivity disorder (ADHD) was numerically higher in the bipolar disorder (BD) + cADHD group compared with the BD − cADHD group
The BD + cADHD group was significantly younger at age of first psychiatric symptom, as well as at age of first affective episode

Summary

Introduction

The prevalence of comorbid attention-deficit/hyperactivity disorder (ADHD) in adults with bipolar disorder (BD) ranges between 9.5 and 28% (Nierenberg et al 2005; Rydén et al 2009; Torres et al 2015). Salarvan et al Int J Bipolar Disord (2019) 7:14 attempts (Nierenberg et al 2005; Torres et al 2015; Harmanci et al 2016), and interpersonal violence (Nierenberg et al 2005; Rydén et al 2009) This means that it is clinically important to identify BD patients with comorbid ADHD. We compare the neuropsychological profiles of bipolar disorder patients with (BD + cADHD) and without (BD − cADHD) childhood attentiondeficit hyperactivity disorder

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