Prevalence and Clinical Impact of Attention-Deficit/Hyperactivity Disorder in inpatients with a primary diagnosis of an affective disorder: A Retrospective Study from a Specialized Inpatient Clinic

Background It is well documented that attention deficit hyperactivity disorder (ADHD) and depression frequently co-occur. The objective of this study was to ascertain the prevalence of ADHD among patients admitted to a ward specializing in affective disorders. Methods Upon admission, each inpatient was required to complete an admission examination, which included the Adult ADHD Self-Report Scale (ASRS-v1.1). Those who met cut-off scores underwent a comprehensive ADHD assessment. Diagnostic data were collected encompassing sociodemographic, medical and psychiatric histories, and a psychopathological examination. Results 58 patients (41.1%) screened positive on the ASRS v1.1 Part A, and 15 (10.6%) met full diagnostic criteria following detailed assessment and sufficient remission of depressive symptoms. Among the 83 ASRS-negative patients, 18 (12.7%) were referred for further evaluation due to anamnestic indicators, resulting in 13 additional clinically confirmed cases (9.2%). The resulting ADHD prevalence was 10.6% based on the structured protocol and 19.9% when clinically judged cases were included. Limitations The findings are limited by the small and specialized inpatient sample, potentially restricting generalizability. ADHD diagnoses were established during depressive episodes, so mood-related diagnostic bias cannot be fully excluded. Conclusions Considering comorbid ADHD in depression is of particular importance. ADHD screening instruments are valuable for identifying ADHD in depressed patients. Furthermore, the results of our study indicate that a rapid onset of depression, as measured by the ODI, may signal hidden ADHD. Recognizing comorbid ADHD has significant clinical implications, influencing both diagnosis and treatment, which can be a game changer in patient outcomes.