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Review
, 17 (1), 302

Adult ADHD and Comorbid Disorders: Clinical Implications of a Dimensional Approach

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Review

Adult ADHD and Comorbid Disorders: Clinical Implications of a Dimensional Approach

Martin A Katzman et al. BMC Psychiatry.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) in the adult population is frequently associated with comorbid psychiatric diseases that complicate its recognition, diagnosis and management.The prevalence of ADHD in the general adult population is 2.5% and it is associated with substantial personal and individual burden. The most frequent comorbid psychopathologies include mood and anxiety disorders, substance use disorders, and personality disorders. There are strong familial links and neurobiological similarities between ADHD and the various associated psychiatric comorbidities. The overlapping symptoms between ADHD and comorbid psychopathologies represent challenges for diagnosis and treatment. Guidelines recommend that when ADHD coexists with other psychopathologies in adults, the most impairing condition should generally be treated first.Early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life. The use of validated assessment scales and high-yield clinical questions can help identify adults with ADHD who could potentially benefit from evidence-based management strategies.

Keywords: Adult ADHD; Neurobiology; Psychiatric comorbidity.

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

Dr. Martin Katzman has received grant support, participated in advisory boards, and/or received honoraria for giving lectures from the following: Canadian Foundation for Innovation, Lotte & John Hecht Memorial Foundation, Allergan, AstraZeneca, Bedrocan, Biotics, Bristol-Myers Squibb, Eli Lilly, Genuine Health, Janssen, Lundbeck, Merck, Otsuka, Pfizer, Purdue, Shire, Sunovion and Tweed.

Dr. Timothy Bilkey has received grant support, participated in advisory boards, and/or received honoraria for giving lectures from the following: Eli Lilly, Janssen, Lundbeck and Shire.

Dr. Pratap Chokka has received grant support, participated in advisory boards, and/or received honoraria for giving lectures from the following: AstraZeneca, Bristol-Myers Squibb, Grey Nuns Hospital, Eli Lilly, Janssen, Lundbeck, Pfizer and Shire.

Dr. Angelo Fallu has acted as a speaker, sat on advisory boards, was a consultant for and/or received honoraria for giving lectures from the following: Bristol-Myers Squibb, Ironshore, Janssen, Lundbeck, Otsuka, Pfizer, Purdue, Shire, and Sunovion.

Dr. Larry Klassen has acted as a speaker, sat on advisory boards, was a consultant for and/or received honoraria for giving lectures from the following: Allergan, Ironshore, Janssen, Lundbeck, Pfizer, Purdue, Shire, and Sunovion.

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Figures

Fig. 1
Fig. 1
Overlapping and distinctive features of ADHD and common psychiatric comorbidities (compiled from: Searight et al., 2000 [149]; Culpepper and Mattingly, 2008 [150]; Klassen et al., 2010 [17]; Bond et al., 2012 [16]; Mancini et al., 1999 [85]; CADDRA, 2011 [107]; Mao and Findling, 2014) [84]

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