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Attention-deficit/hyperactivity disorder and physical multimorbidity: A population-based study

Published online by Cambridge University Press:  23 March 2020

A. Stickley ,
A. Koyanagi ,
H. Takahashi ,
V. Ruchkin ,
Y. Inoue  and
Y. Kamio
A. Stickley*
Affiliation:
Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 OgawahigashiKodaira, Tokyo187-8553, Japan The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge141 89, Sweden Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 HongoBunkyo-ku, Tokyo113-0033, Japan
A. Koyanagi
Affiliation:
Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas42, Sant Boi de LlobregatBarcelona08830, Spain Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11Madrid28029, Spain
H. Takahashi
Affiliation:
Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 OgawahigashiKodaira, Tokyo187-8553, Japan
V. Ruchkin
Affiliation:
Child Study Centre, Yale University Medical School, New Haven, CT06520, USA Department of Child and Adolescent Psychiatry, Division of Neuroscience, Uppsala University, Uppsala751 85, Sweden
Y. Inoue
Affiliation:
Carolina Population Center, The University of North Carolina at Chapel Hill137, East Franklin StreetChapel Hill, NC, USA
Y. Kamio
Affiliation:
Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 OgawahigashiKodaira, Tokyo187-8553, Japan
*
*Corresponding author. Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan. Fax: +81 42 346 1944. E-mail address:[email protected] (A. Stickley).
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Abstract

Background:

There has been little research on the association of attention-deficit/hyperactivity disorder (ADHD) with co-occurring physical diseases. The aim of this study was to examine the association between possible ADHD and physical multimorbidity (i.e. = 2 physical diseases) among adults in the English general population.

Methods:

Data were analyzed from 7274 individuals aged = 18 years that came from the Adult Psychiatric Morbidity Survey 2007. ADHD symptoms were assessed with the Adult Self-Report Scale (ASRS) Screener. Information was also obtained on 20 self-reported doctor/other health professional diagnosed physical health conditions present in the past 12 months. Multivariable logistic regression and mediation analyses were conducted to assess the associations.

Results:

There was a monotonic relation between the number of physical diseases and possible ADHD (ASRS score = 14). Compared to those with no diseases, individuals with = 5 diseases had over 3 times higher odds for possible ADHD (odds ratio [OR]: 3.30, 95% confidence interval [CI]: 2.48–4.37). This association was observed in all age groups. Stressful life events (% mediated 10.3–24.3%), disordered eating (6.8%), depression (12.8%), and anxiety (24.8%) were significant mediators in the association between possible ADHD and physical multimorbidity.

Conclusion:

Adults that screen positive for ADHD are at an increased risk for multimorbidity and several factors are important in this association. As many adults with ADHD remain undiagnosed, the results of this study highlight the importance of detecting adult ADHD as it may confer an increased risk for poorer health outcomes, including physical multimorbidity.

Keywords

ADHDMultimorbidityPhysical diseaseEpidemiologyStress
Type
Original article
Information
European Psychiatry , Volume 45 , September 2017 , pp. 227 - 234
Copyright
Copyright © European Psychiatric Association 2017

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References

American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 5th ed., Arlington, VA: APA; 2013.CrossRefGoogle Scholar
Volkow, NDSwanson, JMClinical practice: adult attention-deficit hyperactivity disorder. N Engl J Med 2013; 369: 1935–1944.CrossRefGoogle ScholarPubMed
Simon, VCzobor, PBálint, SMészáros, ABitter, IPrevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br J Psychiatry 2009; 194: 204–211.CrossRefGoogle ScholarPubMed
Fasmer, OBHalmøy, AEagan, TMOedegaard, KJHaavik, JAdult attention-deficit hyperactivity disorder is associated with asthma. BMC Psychiatry 2011;11:128.CrossRefGoogle ScholarPubMed
Spencer, TJFaraone, SVTarko, LMcDermott, KBiederman, JAttention-deficit/hyperactivity disorder and adverse health outcomes in adults. J Nerv Ment Dis 2014; 202: 725–731.CrossRefGoogle ScholarPubMed
Fasmer, OBHalmøy, AOedegaard, KJHaavik, JAdult attention-deficit hyperactivity disorder is associated with migraine headaches. Eur Arch Psychiatry Clin Neurosci 2011; 261: 595–602.CrossRefGoogle ScholarPubMed
Hodgkins, PMontejano, LSasané, RHuse, DCost of illness and comorbidities in adults diagnosed with attention-deficit/hyperactivity disorder: a retrospective analysis. Prim Care Companion CNS Disord 2011;13 [pii: PCC.10m01030].CrossRefGoogle Scholar
Semeijn, EJKooij, JJComijs, HCMichielsen, MDeeg, DJBeekman, ATAttention-deficit/hyperactivity disorder, physical health, and lifestyle in older adults. J Am Geriatr Soc 2013; 61: 882–887.CrossRefGoogle ScholarPubMed
Instanes, JTKlungsøyr, KHalmøy, AFasmer, OBHaavik, JAdult ADHD and comorbid somatic disease: a systematic literature review. J Atten Disord 2016 http://dx.doi.org/10.1177/1087054716669589 [in press. pii: 1087054716669589].CrossRefGoogle Scholar
van den Akker, MBuntinx, FKnottnerus, JAComorbidity or multimorbidity: what's in a name? A review of literature. Eur J Gen Pract 1996; 2: 65–70.CrossRefGoogle Scholar
Taylor, AWPrice, KGill, TKAdams, RPilkington, RCarrangis, N, et al.Multimorbidity – not just an older person's issue. Results from an Australian biomedical study. BMC Public Health 2010;10:718.CrossRefGoogle Scholar
Kadam, UTCroft, PR North Staffordshire GP Consortium Group Clinical multimorbidity and physical function in older adults: a record and health status linkage study in general practice. Fam Pract 2007; 24: 412–419.CrossRefGoogle ScholarPubMed
Fortin, MLapointe, LHudon, CVanasse, ANtetu, ALMaltais, DMultimorbidity and quality of life in primary care: a systematic review. Health Qual Life Outcomes 2004;2:51.CrossRefGoogle ScholarPubMed
Glynn, LGValderas, JMHealy, PBurke, ENewell, JGillespie, P, et al.The prevalence of multimorbidity in primary care and its effect on health care utilization and cost. Fam Pract 2011; 28: 516–523.CrossRefGoogle Scholar
Loprinzi, PDAddoh, OJoyner, CMultimorbidity, mortality, and physical activity. Chronic Illn 2016; 12: 272–280.CrossRefGoogle ScholarPubMed
Rooney, MChronis-Tuscano, AYoon, YSubstance use in college students with ADHD. J Atten Disord 2012; 16: 221–234.CrossRefGoogle ScholarPubMed
Connolly, RDSpeed, DHesson, JProbabilities of ADD/ADHD and related substance use among Canadian adults. J Atten Disord 2016 http://dx.doi.org/10.1177/1087054716647474 [in press. pii: 1087054716647474].CrossRefGoogle Scholar
Estévez, NDey, MEich-Höchli, DFoster, SGmel, GMohler-Kuo, MAdult attention-deficit/hyperactivity disorder and its association with substance use and substance use disorders in young men. Epidemiol Psychiatr Sci 2016; 25: 255–266.CrossRefGoogle ScholarPubMed
Kessler, RCAdler, LBarkley, RBiederman, JConners, CKDemler, O, et al.The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry 2006; 163: 716–723.CrossRefGoogle ScholarPubMed
Sobanski, EPsychiatric comorbidity in adults with attention-deficit/hyperactivity disorder (ADHD). Eur Arch Psychiatry Clin Neurosci 2006;256:i26–i31.CrossRefGoogle Scholar
Cortese, SMoreira-Maia, CRSt Fleur, DMorcillo-Peñalver, CRohde, LAFaraone, SVAssociation between ADHD and obesity: a systematic review and meta-analysis. Am J Psychiatry 2016; 173: 34–43.CrossRefGoogle ScholarPubMed
Nigg, JTJohnstone, JMMusser, EDLong, HGWilloughby, MTShannon, JAttention-deficit/hyperactivity disorder (ADHD) and being overweight/obesity: new data and meta-analysis. Clin Psychol Rev 2016; 43: 67–79.CrossRefGoogle ScholarPubMed
Garcia, CRBau, CHSilva, KLCallegari-Jacques, SMSalgado, CAFischer, AG, et al.The burdened life of adults with ADHD: impairment beyond comorbidity. Eur Psychiatry 2012; 27: 309–313.CrossRefGoogle ScholarPubMed
Semeijn, EJComijs, HCKooij, JJMichielsen, MBeekman, ATDeeg, DJThe role of adverse life events on depression in older adults with ADHD. J Affect Disord 2015; 174: 574–579.CrossRefGoogle ScholarPubMed
Brown, NMBrown, SNBriggs, RDGerman, MBelamarich, PFOyeku, SOAssociations between adverse childhood experiences and ADHD diagnosis and severity. Acad Pediatr 2017; 17: 349–355.CrossRefGoogle ScholarPubMed
Fortin, MSoubhi, HHudon, CBayliss, EAvan den Akker, MMultimorbidity's many challenges. BMJ 2007; 334: 1016–1017.CrossRefGoogle ScholarPubMed
Salive, MEMultimorbidity in older adults. Epidemiol Rev 2013; 35: 75–83.CrossRefGoogle ScholarPubMed
Dalsgaard, SØstergaard, SDLeckman, JFMortensen, PBPedersen, MGMortality in children, adolescents, and adults with attention-deficit hyperactivity disorder: a nationwide cohort study. Lancet 2015; 385: 2190–2196.CrossRefGoogle ScholarPubMed
The Emerging Risk Factors Collaboration Association of cardio-metabolic multimorbidity with mortality. JAMA 2015; 314: 52–60.Google Scholar
McManus, SMeltzer, HBrugha, TBebbington, PJenkins, RAdult psychiatric morbidity in England, 2007: results of a household survey London: National Centre for Social Research; 2009Google Scholar
Kessler, RCAdler, LAmes, MDemler, OFaraone, SHiripi, E, et al.The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 2005; 35: 245–256.CrossRefGoogle Scholar
Kessler, RCAdler, LAGruber, MJSarawate, CASpencer, TVan Brunt, DLValidity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener in a representative sample of health plan members. Int J Methods Psychiatr Res 2007; 16: 52–65.CrossRefGoogle Scholar
Reyes, MMSchneekloth, TDHitschfeld, MJGeske, JRAtkinson, DLKarpyak, VMThe clinical utility of ASRS-v1.1 for identifying ADHD in alcoholics using PRISM as the reference standard. J Atten Disord 2016 http://dx.doi.org/10.1177/1087054716646450 [pii: 1087054716646450. Epub ahead of print].CrossRefGoogle Scholar
Kingston, DAAhmed, AGGray, JBradford, JSeto, MCThe assessment and diagnosis of attention-deficit hyperactivity disorder in adult forensic psychiatric outpatients. J Psychopathol Behav Assess 2013; 35: 293–300.CrossRefGoogle Scholar
Saunders, JBAasland, OGBabor, TFDe La Fuente, JRGrant, MDevelopment of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption—II. Addiction 1993; 88: 791–804.CrossRefGoogle Scholar
Stockwell, TSitharthan, TMcGrath, DLang, EThe measurement of alcohol dependence and impaired control in community samples. Addiction 1994; 89: 167–174.CrossRefGoogle ScholarPubMed
Morgan, JFReid, FLacey, JHThe SCOFF questionnaire: assessment of a new screening tool for eating disorders. BMJ 1999; 319: 1467–1468.CrossRefGoogle ScholarPubMed
Lewis, GPelosi, AJAraya, RDunn, GMeasuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med 1992; 22: 465–486.CrossRefGoogle ScholarPubMed
Breen, RKarlson, KBHolm, ATotal, direct, and indirect effects in logit and probit models. Sociol Methods Res 2013; 42: 164–191.CrossRefGoogle Scholar
Fortin, MHaggerty, JAlmirall, JBouhali, TSasseville, MLemieux, MLifestyle factors and multimorbidity: a cross-sectional study. BMC Public Health 2014;14:686.CrossRefGoogle ScholarPubMed
Smith, DJCourt, HMcLean, GMartin, DLangan Martin, JGuthrie, B, et al.Depression and multimorbidity: a cross-sectional study of 1,751,841 patients in primary care. J Clin Psychiatry 2014; 75: 1202–1208.CrossRefGoogle ScholarPubMed
Ottman, RLipton, RBEttinger, ABCramer, JAReed, MLMorrison, A, et al.Comorbidities of epilepsy: results from the Epilepsy Comorbidities and Health (EPIC) survey. Epilepsia 2011; 52: 308–315.Google ScholarPubMed
Faraone, SVAttention-deficit hyperactivity disorder and premature death. Lancet 2015; 385: 2132–2133.CrossRefGoogle ScholarPubMed
Raevuori, AHaukka, JVaarala, OSuvisaari, JMGissler, MGrainger, M, et al.The increased risk for autoimmune diseases in patients with eating disorders. PLos One 2014;9:e104845.CrossRefGoogle ScholarPubMed
Thornton, LMWatson, HJJangmo, AWelch, EWiklund, Cvon Hausswolff-Juhlin, Y, et al.Binge eating disorder in the Swedish national registers: somatic comorbidity. Int J Eat Disord 2017; 50: 58–65.CrossRefGoogle ScholarPubMed
Bulik, CMReichborn-Kjennerud, TMedical morbidity in binge eating disorder. Int J Eat Disord 2003;34:S39–S46.CrossRefGoogle ScholarPubMed
Hudson, JIHiripi, EPope, HG Jr.Kessler, RCThe prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry 2007; 61: 348–358.CrossRefGoogle ScholarPubMed
Nazar, BPPinna, CMCoutinho, GSegenreich, DDuchesne, MAppolinario, JC, et al.Review of literature of attention-deficit/hyperactivity disorder with comorbid eating disorders. Rev Bras Psiquiatr 2008; 30: 384–389.CrossRefGoogle ScholarPubMed
Sareen, JJacobi, FCox, BJBelik, SLClara, IStein, MBDisability and poor quality of life associated with comorbid anxiety disorders and physical conditions. Arch Intern Med 2006; 166: 2109–2116.CrossRefGoogle ScholarPubMed
Moussavi, SChatterji, SVerdes, ETandon, APatel, VUstun, BDepression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 2007; 370: 851–858.CrossRefGoogle ScholarPubMed
Roy-Byrne, PPDavidson, KWKessler, RCAsmundson, GJGoodwin, RDKubzansky, L, et al.Anxiety disorders and comorbid medical illness. Gen Hosp Psychiatry 2008; 30: 208–225.CrossRefGoogle ScholarPubMed
Kiecolt-Glaser, JKGlaser, RDepression and immune function: central pathways to morbidity and mortality. J Psychosom Res 2002; 53: 873–876.CrossRefGoogle ScholarPubMed
DiMatteo, MRLepper, HSCroghan, TWDepression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000; 160: 2101–2107.CrossRefGoogle ScholarPubMed
Felitti, VJAnda, RFNordenberg, DWilliamson, DFSpitz, AMEdwards, V, et al.Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 1998; 14: 245–258.CrossRefGoogle ScholarPubMed
Renzaho, AMHoung, BOldroyd, JNicholson, JMD’esposito, FOldenburg, BStressful life events and the onset of chronic diseases among Australian adults: findings from a longitudinal survey. Eur J Public Health 2014; 24: 57–62.CrossRefGoogle ScholarPubMed
Sinnott, CMcHugh, SFitzgerald, APBradley, CPKearney, PMPsychosocial complexity in multimorbidity: the legacy of adverse childhood experiences. Fam Pract 2015; 32: 269–275.CrossRefGoogle ScholarPubMed
Fagundes, CPGlaser, RKiecolt-Glaser, JKStressful early-life experiences and immune dysregulation across the lifespan. Brain Behav Immun 2013; 27: 8–12.CrossRefGoogle ScholarPubMed
Fagundes, CPWay, BEarly-life stress and adult inflammation. Curr Dir Psychol Sci 2014; 23: 277–283.CrossRefGoogle Scholar
Kemeny, MESchedlowski, MUnderstanding the interaction between psychosocial stress and immune-related diseases: a stepwise progression. Brain Behav Immun 2007; 21: 1009–1018.CrossRefGoogle ScholarPubMed
Hirvikoski, TLindholm, TNordenström, ANordström, ALLajic, SHigh self-perceived stress and many stressors, but normal diurnal cortisol rhythm, in adults with ADHD (attention-deficit/hyperactivity disorder). Horm Behav 2009; 55: 418–424.CrossRefGoogle Scholar
Combs, MACanu, WHBroman-Fulks, JJRocheleau, CANieman, DCPerceived stress and ADHD symptoms in adults. J Atten Disord 2015; 19: 425–434.CrossRefGoogle ScholarPubMed
Pitts, MMangle, LAsherson, PImpairments, diagnosis and treatments associated with attention-deficit/hyperactivity disorder (ADHD) in UK adults: results from the lifetime impairment survey. Arch Psychiatr Nurs 2015; 29: 56–63.CrossRefGoogle ScholarPubMed
Michielsen, MComijs, HCAartsen, MJSemeijn, EJBeekman, ATDeeg, DJ, et al.The relationships between ADHD and social functioning and participation in older adults in a population-based study. J Atten Disord 2015; 19: 368–379.CrossRefGoogle ScholarPubMed
Brod, MSchmitt, EGoodwin, MHodgkins, PNiebler, GADHD burden of illness in older adults: a life course perspective. Qual Life Res 2012; 21: 795–799.CrossRefGoogle ScholarPubMed
Cohen, SSocial relationships and health. Am Psychol 2004; 59: 676–684.CrossRefGoogle ScholarPubMed
Li, DSham, PCOwen, MJHe, LMeta-analysis shows significant association between dopamine system genes and attention-deficit hyperactivity disorder (ADHD). Hum Mol Genet 2006; 15: 2276–2284.CrossRefGoogle Scholar
Ettinger, ABOttman, RLipton, RBCramer, JAFanning, KMReed, MLAttention-deficit/hyperactivity disorder symptoms in adults with self-reported epilepsy: results from a national epidemiologic survey of epilepsy. Epilepsia 2015; 56: 218–224.CrossRefGoogle ScholarPubMed
Sandra Kooij, JJMarije Boonstra, ASwinkels, SHBekker, EMde Noord, IBuitelaar, JKReliability, validity, and utility of instruments for self-report and informant report concerning symptoms of ADHD in adult patients. J Atten Disord 2008; 11: 445–458.CrossRefGoogle ScholarPubMed
Okura, YUrban, LHMahoney, DWJacobsen, SJRodeheffer, RJAgreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. J Clin Epidemiol 2004; 57: 1096–1103.CrossRefGoogle ScholarPubMed
Gasquoine, PGCognitive impairment in common, noncentral nervous system medical conditions of adults and the elderly. Clin Exp Neuropsychol 2011; 33: 486–496.CrossRefGoogle ScholarPubMed
Asherson, PAkehurst, RKooij, JJHuss, MBeusterien, KSasané, R, et al.Under diagnosis of adult ADHD: cultural influences and societal burden. J Atten Disord 2012;16:20S–38S.CrossRefGoogle ScholarPubMed
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