Is ADHD severity in adults associated with the lifetime prevalence of comorbid depressive episodes and anxiety disorders?

Abstract

PURPOSE: The objective of the present study was to examine the association between ADHD severity and the lifetime prevalence of comorbid depressive episodes and anxiety disorders in adults with ADHD. SUBJECTS/MATERIALS AND METHODS: Analyses were based on data of the Conner's Adult ADHD Rating Scale (CAARS) and a parent study examining the epidemiology of adult ADHD in 17 GP practices in Budapest, Hungary. Subjects between 18 and 60 years were included in the screening phase (n=3529). Out of 279 positively screened subjects 161 participated in a clinical interview and completed the CAARS to confirm the diagnosis. We applied four diagnostic criteria: "DSM-IV"; "No-onset" (DSM-IV criteria without the specific requirement for onset); "Symptoms-only" (DSM-IV symptom criterion only); and "Reduced symptoms-only" (DSM-IV symptom criterion with a reduced threshold for symptom count). The MINI PLUS 5.0 was used to assess psychiatric comorbidity. RESULTS: ADHD severity, as measured by the CAARS ADHD Index, showed a significant positive association with the prevalence of comorbid depressive episodes in all but the "ADHD_No-onset" group ("DSM-IV": F[1.23]=8.39, P=0.0081; "No-onset": F(1.27)=0.97, P=0.3346; "Symptoms-only": F[1.55]=30.79, P<0.0001; "Reduced symptoms-only": F(1.62)=26.69, P<0.0001). DISCUSSION AND CONCLUSION: Results indicate that ADHD symptom severity increases in association with lifetime comorbidity with depression.