Psychiatric comorbid patterns in adults with attention-deficit hyperactivity disorder: Treatment effect and subtypes

Psychiatric comorbidities are common in individuals with attention-deficit/hyperactivity disorder (ADHD). In this study, we sought to evaluate the effects of medication and childhood ADHD subtypes on psychiatric comorbidities among adults with ADHD as compared to healthy adult controls. We assessed 121 drug-naïve adults with ADHD, 93 treated adults with ADHD, and 145 healthy controls (age 18–36 years) using semi-structured psychiatric interviews, intelligence tests, and medical records. Drug-naïve adults with ADHD had more comorbidities than treated adults with ADHD and controls. Childhood ADHD-combined subtype, relative to ADHD-inattentive subtype, was associated with higher risks of comorbidities. Current medication treatment was associate with a higher risk for anxiety disorders, and longer treatment duration was associated with lower risks of mood disorders and sleep disorders. Our results indicate that no medication treatment, short treatment duration, and childhood ADHD-combined subtype are associated with increased risks for psychiatric comorbidities among adults with ADHD.

注意缺陷多动障碍（attention-deficit/hyperactivity disorder，ADHD）患者常出现精神共病。本研究旨在对比健康成年对照人群，评估药物治疗与儿童期ADHD亚型对成年ADHD患者精神共病情况的影响。本研究采用半结构化精神访谈、智力测验及病历资料审查方式，纳入121名未接受过药物治疗的成年ADHD患者、93名接受药物治疗的成年ADHD患者，以及145名年龄18~36岁的健康对照者。未接受过药物治疗的成年ADHD患者的共病率高于接受药物治疗的ADHD患者及健康对照者；相较于ADHD注意力缺陷亚型，儿童期ADHD混合型亚型与更高的共病风险相关；当前药物治疗与焦虑障碍的更高发病风险相关，而更长的治疗时长则与心境障碍及睡眠障碍的更低发病风险相关。本研究结果表明，未接受药物治疗、较短的治疗时长，以及儿童期ADHD混合型亚型，均与成年ADHD患者精神共病风险升高相关。