Could comorbid bipolar disorder account for a significant share of executive function deficits in adults with attention‐deficit hyperactivity disorder?

Abstract

WCST impairments among patients with ADHD seem to be to a large extent attributable to comorbid BD. Although other executive function deficits (e.g., in the inhibitory control domain) have been demonstrated to accompany ADHD, the present findings suggest that set-shifting deficits are strongly related to comorbid BD.

Adult attention deficit/hyperactivity disorder among the prison inmates: An investigation of the executive function differences and comorbidity effects

“…The results were consistent with pervious findings (Bramham et al, ; Garcia et al, ; Marchetta et al, ; Nigg et al, ; Salomone et al, ; Sobanski et al, ). Silva et al () and Silva et al () indicated that the problem of inhibition can be considered as a significant component in ADHD and bipolar disorder. In addition, the impulsivity characteristic seen in both disorders can imply a component of emotional dysregulation in both abnormalities.…”

“…The results of regression analyses showed that among the comorbid disorders, only depression disorder and bipolar disorder could predict neuropsychological deficits in prison inmate adult with ADHD. A review of studies on similarities between depression and bipolar disorders and ADHD in their neuropsychological functions indicated that they might share deficits in emotional dysregulation (Hegerl & Hensch, ) and sustained attention (Silva et al, , ; Young, Sedgwick, et al, ). Since depression disorder and bipolar disorder as the two comorbidity disorders are the most commonly used to predict the problems of adult prison inmates with ADHD, it is important to consider the need for assessment as well as the related interventions, including cognitive‐behavioural therapy focusing on behavioural activation and improving cognitive processes of these individuals.…”

“…A few comorbid disorders associated with ADHD, which are also related to executive dysfunctions include bipolar disorders (Ryan et al, ), anxiety disorders (Fujii et al, ), borderline personality disorders (Hagenhoff et al, ), and antisocial personality disorders (De Brito, Viding, Kumari, Blackwood, & Hodgins, ). Although a few studies have evaluated the EF deficits in adults with ADHD during controlling for comorbidities (Bramham et al, ; Marchetta, Hurks, Krabbendam, & Jolles, ; Nigg et al, ; Silva et al, ), the findings of a study suggest that Wisconsin Card Sorting Test (WCST) impairment among patients with ADHD seems to be strongly attributable to comorbid bipolar disorder (Silva et al, ). Addressing the issue in inmates with ADHD seems even more complicated because they report more ADHD symptoms (Ginsberg et al, ) and more comorbid disorders (Rösler et al, ) than the ADHD individuals with no criminal history.…”

Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies

“…BD is often accompanied by multiple medical comorbidities, so recognizing them is an important issue, since some of them may complicate not only the course and treatment of patients but also may contribute to the magnitude of cognitive dysfunction adding other potential pathophysiological routes. Some conditions that have been studied and could constitute additional factors influencing neurocognitive performance are substance use disorders, anxiety, the attention deficit hyperactivity disorder, and overweight or obesity (van Gorp et al, 1998; Levy et al, 2008; Sanchez-Moreno et al, 2009; Balanzá-Martínez et al, 2010; Yim et al, 2012; Depp et al, 2014; Silva et al, 2014; Lackner et al, 2015; Volkert et al, 2015; I. Torres, unpublished observations). Importantly, treating some of these conditions may ameliorate cognitive impairment since some of them may be modifiable (see Table 2).…”

Amphetamine Modestly Improves Conners’ Continuous Performance Test Performance in Healthy Adults

“…Results in adults with ADHD are mixed (Antshel et al, 2010; Biederman et al, 2009; Silva et al, 2014; L. L. Weyandt & DuPaul, 2006; Lisa L. Weyandt, Linterman, & Rice, 1995), and thus, it remains unclear whether the WCST deficits observed with ADHD persist into adulthood.…”