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Common psychiatric and metabolic comorbidity of adult attention-deficit/hyperactivity disorder: A population-based cross-sectional study

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  • Qi Chen, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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  • Catharina A Hartman, Department of Psychiatry, University of Groningen, University Medical Center Groningen, P.O. Box 72, 9700 AB Groningen, The Netherlands.
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  • Jan Haavik, K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway; Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York.
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  • Jaanus Harro, Division of Neuropsychopharmacology, Department of Psychology, University of Tartu, Tartu, Estonia.
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  • Kari Klungsøyr, Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway.
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  • Tor-Arne Hegvik, K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway; Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York.
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  • Rob Wanders, Department of Psychiatry, University of Groningen, University Medical Center Groningen, P.O. Box 72, 9700 AB Groningen, The Netherlands.
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  • Cæcilie Ottosen
  • Søren Dalsgaard, g Department for Child and Adolescent Psychiatry , Hospital of Telemark , Kragerø , Norway.
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  • Stephen V Faraone, Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, New York, United States of America.
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  • Henrik Larsson, Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm County Council, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden.

Attention-deficit/hyperactivity disorder (ADHD) is often comorbid with other psychiatric conditions in adults. Yet, less is known about its relationship with common metabolic disorders and how sex and ageing affect the overall comorbidity patterns of adult ADHD. We aimed to examine associations of adult ADHD with several common psychiatric and metabolic conditions. Through the linkage of multiple Swedish national registers, 5,551,807 adults aged 18 to 64 years and living in Sweden on December 31, 2013 were identified and assessed for clinical diagnoses of adult ADHD, substance use disorder (SUD), depression, bipolar disorder, anxiety, type 2 diabetes mellitus (T2DM), and hypertension. Logistic regression models and regression standardization method were employed to obtain estimates of prevalence, prevalence difference (PD), and prevalence ratio (PR). All comorbid conditions of interest were more prevalent in adults with ADHD (3.90% to 44.65%) than in those without (0.72% to 4.89%), with the estimated PRs being over nine for psychiatric conditions (p < 0.001) and around two for metabolic conditions (p < 0.001). Sex differences in the prevalence of comorbidities were observed among adults with ADHD. Effect modification by sex was detected on the additive scale and/or multiplicative scale for the associations of adult ADHD with all comorbidities. ADHD remained associated with all comorbidities in older adults aged 50 to 64 when all conditions were assessed from age 50 onwards. The comorbidity patterns of adult ADHD underscore the severity and clinical complexity of the disorder. Clinicians should remain vigilant for a wide range of psychiatric and metabolic problems in ADHD affected adults of all ages and both sexes.

Original languageEnglish
Article numbere0204516
JournalPLOS ONE
Volume13
Issue9
Number of pages12
ISSN1932-6203
DOIs
Publication statusPublished - 2018

    Research areas

  • ADHD, ASSOCIATION, DEFICIT HYPERACTIVITY DISORDER, DSM-IV, HYPERTENSION, METAANALYSIS, OBESITY, PREVALENCE, SMOKING, SYMPTOMS

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