What do childhood attention deficit/hyperactivity symptoms in depressed adults tell us about the bipolar spectrum?
BACKGROUND
This study aims to establish if adult patients with major depressive disorder (MDD) and childhood Attention Deficit/Hyperactivity disorder (ADHD) symptoms would be more frequently within the bipolar spectrum than depressed patients without childhood ADHD.


METHODS
This study was carried out in outpatients recruited by psychiatrists in private practice, with 3963 participants being included in the final sample. Clinicians filled out questionnaires about current depressive symptoms in their patients, lifetime bipolar symptoms, global assessment of functioning and parental history of both major depression and bipolar disorder. Patients assessed current level of anxiety and depressive symptoms and antecedents of childhood ADHD symptoms.


RESULTS
Depressed adults with significant childhood ADHD symptoms had a specific pattern of their major depressive episode compared to depressed patients without such symptoms. Subjects with childhood ADHD symptoms were more likely to report lifetime symptoms of mania/hypomania and to have a parent with type I or II bipolar disorder. The developmental trajectories of familial risk for lifetime bipolar symptoms showed that parental bipolar disorder influenced lifetime bipolar symptoms both through a direct pathway and an indirect pathway involving childhood ADHD symptoms. Childhood ADHD and number of depressive symptoms both made direct contributions to lifetime bipolar symptoms.
['Purper-Ouakil|D|D|', 'Porfirio|M C|MC|', 'Le Strat|Y|Y|', 'Falissard|B|B|', 'Gorwood|P|P|', 'Masi|G|G|']
D000328:Adult D001289:Attention Deficit Disorder with Hyperactivity D001714:Bipolar Disorder D003865:Depressive Disorder, Major D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D010045:Outpatients D010290:Parents D011795:Surveys and Questionnaires D063189:Symptom Assessment
Depressive disorder Bipolar disorder Anxiety disorders Attention deficit hyperactivity disorder