Comorbidity of adult ADHD and substance use disorder in a sample of inpatients bipolar disorder in Iran

Abstract

Backgrounds The study of the relationship between adult Attention deficit hyperactivity disorder (ADHD) and bipolar disorder has received more attention in recent years and there is limited information in this area. On the other hand, there is a significant comorbidity between ADHD and bipolar disorder with substance use disorder. In this study, we investigated the prevalence of comorbidity of adult ADHD and substance use disorder among a group of bipolar patients admitted to a psychiatric hospital. Methods One hundred fifty patients from a total of 200 consecutive patients who were referred to the emergency department of Roozbeh Psychiatric Hospital in Tehran, diagnosed with bipolar disorder based on the initial psychiatric interview and needed hospitalization, were evaluated again by an experienced faculty member psychiatrist by using a subsequent interview based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition(DSM-5). They were evaluated using the Structured Clinical Interview for DSM-5 (SCID-5) questionnaire to confirm the diagnosis of bipolar disorder and the comorbidity of adult ADHD and substance use disorder. Results From 150 patients diagnosed with bipolar disorder, 106 patients (70.7%) had adult ADHD. 89 patients (59.3%) had substance use disorder and 58 patients (38.7%) had both of these comorbidities with bipolar disorder. Comorbidity of adult ADHD was associated with the earlier onset of the first mood episode in bipolar disorder (p value = 0.025). There was no statistically significant relationship between substance use disorder and age of onset of the first episode. (P value = 0.57). Conclusions Due to the limitations of studies on adult ADHD comorbidity with bipolar disorder, especially in hospital settings, as well as the increased risk of association with substance use disorder, further multicenter studies in this area with larger sample sizes can increase awareness in this regard.

Analisis Penyalahgunaan Zat sebagai Faktor Risiko Kejadian Gangguan Bipolar pada Orang Dewasa

“…Artikel-artikel ini merupakan hasil penelitian yang dilakukan di Norwegia, Australia, Spanyol, Dermark dan Iran. Semua penelitian yang di-review menggunakan sampel pasien dewasa yang didiagnosis gangguan bipolar (19)(20)(21)(22)(23) (24).…”

“…Dievaluasi menggunakan kuesioner Structured Clinical Interview DSM-V untuk memastikan diagnosis gangguan bipolar dan komorbiditas ADHD pada orang dewasa serta gangguan penggunaan narkoba. Pada penelitian ini tidak ditemukan adanya hubungan yang signifikan antara gangguan penyalahgunaan zat dan usia saat terjadinya episode pertama (24).…”

“…Pasien gangguan bipolar yang diteliti pada kelompok umur dibawah 18 tahun, 50 dari 86 pasien (58,1%), pada kelompok umur 18-25 tahun, 26 dari 45 pasien (57,8%), pada kelompok umur diatas 25 tahun, 13 dari 19 pasien (68,4%), dan dengan total keseluruhan 89 dari 150 pasien (59,3%) pasien gangguan bipolar mengalami gangguan penyalahgunaan zat. Berdasarkan hasil uji Fisher's exact, tidak ada hubungan yang signifikan secara statistik antara penggunaan narkoba dan usia pertama kali terjadinya episode (24).…”