Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder that affects children, adolescents, and adults worldwide. It is primarily characterised by impaired sustained attention, increased impulsivity, and hyperactivity.[1] The prevalence of ADHD among school-aged children is estimated to be 5–8%, and of these, 60–85% continue to meet diagnostic criteria during adolescence. Up to 60% of individuals remain symptomatic in adulthood.[2] Adult ADHD is frequently associated with functional and psychosocial impairments, including difficulties in emotional regulation, memory, executive functioning, decision-making, and behavioural inhibition.[8]

Approximately 80% of adults with ADHD present with at least one additional psychiatric comorbidity, including mood disorders, anxiety disorders, other neurodevelopmental and behavioural disorders, substance use disorders, and personality disorders such as borderline and antisocial personality disorders. Mood disorders are among the most prevalent comorbidities.[8]

Bipolar disorder and ADHD may coexist, particularly bipolar II disorder, which involves hypomanic and depressive episodes. Both disorders share symptoms such as increased activity, distractibility, impulsivity, and rapid speech, though these are episodic in bipolar disorder and usually persistent in ADHD. Their co- occurrence is associated with an earlier onset, chronic course, and shorter recovery periods between episodes.[13] Unipolar depressive disorders also commonly occur in adults with ADHD, significantly increasing suicide risk. [25– 32]

ADHD along with comorbidity related symptoms lead to dysfunction in many parts of life including- performance in academics or work, along with social and interpersonal relationship impairments.[7] This leads to more impairment, worse results, increased resistance to treatment, and even higher costs.[9]

While evaluating of adult ADHD other co-occurring psychiatric disorders should be mentioned in the diagnostic process and a treatment structure should be made. The decision of which disorder to treat first should be based upon the degree of clinical impairment of ADHD and co-morbidities respectively.[10]

In this study we are trying to estimate the prevalence of mood disorders among the adult ADHD patients in a tertiary medical centre of East India.

AIMS:

To find out the prevalence of mood disorders among adult ADHD patients. To study the sociodemographic profile of patients with adult ADHD.

This Cross- sectional hospital based study was done in the Department of Psychiatry, Patna Medical College & Hospital, Patna, Bihar during December 2020- December 2022. The sample includes 100 diagnosed cases of adult ADHD, aged between 18 to 60 years and without any debilitating physical illnesses and mental retardation. After obtaining written informed consent the sociodemographic data was collected from the participants using a Semi- structured socio-demographic Performa. The diagnosis of adult ADHD was done using the diagnostic criteria of Diagnostic and statistical Manual of Mental Disorders (DSM-5) by two qualified psychiatrists. Beck’s depression Inventory ll and The Young Mania Rating Scale (YMRS) were used to know the prevalence of mood disorders (depressive and manic disorders respectively. Ethical standards were maintained throughout the study. All the data were analyzed using SPSS package (Stata, version 26.0 SPSS INC, Chicago, IL, USA) for windows.The data were presented as descriptive statistics for continuous variables and percentage for categorical variables and was subjected Chi-square test, t test. Other values were represented in number, proportions (%) and mean ± SD.

SOCIODEMOGRAPHIC DETAILS:

Table 1: Demographic characteristics of the sample

In our study total 100 adult ADHD patients participated. Among them majority (67%) were from the age group of 18-25 years. Male (89%) were much more than the female participants (11%). Most of them (73%) were graduate. 90 % were following Hindu religion, while 9 % Muslim and 1 % Buddhism. Majority of them (74%) were living in urban area. 71% were unmarried and 29% married.

Back’s Depression Inventory II scale was applied in all the adult ADHD participants to know the prevalence and grade of depressive symptoms. Total 47 of them (47%) had depressive symptoms. It was observed that majority of them had Moderate depression 27 (27%) followed by Mild depression (3%), severe depression (13%) and minimal depression (3%). Moderate depression was significantly more than the other types. (p<0.001)

Table 2: Beck’s Depression Inventory II Scale : Severity of depressive symptoms among adult ADHD patients

The Young Mania Rating Scale (YMRS) was used to identify the manic symptoms among the participants. Total 17 % had manic symptoms and out of them majority had Mild manic symptoms (9%), followed by Moderate (5%) and Severe manic symptoms (3%). It was found that among the participants with manic symptoms mild symptoms were significantly more than other types (p<0.001).

Table 3: Young Mania Rating Scale (YMRS) : Severity of Manic symptoms among adult ADHD patients

A high proportion of childhood ADHD persist into the adulthood which serves as a factor leading to various co-morbid psychiatric disorders in such patients. The study was aimed to find percentage of mood disorders in the patients with Adult ADHD and to study their sociodemographic characteristics.

It was seen that the majority of the patients were in youthful and productive years of life between 18-25 years. Most of them were from a urban background. Males were significantly more than the female participants. Around two third were unmarried and had an graduate degree. Hindu participants outnumbered the other religions. We found 47% of the participants had depressive symptoms cross sectionally, and out of them moderate level of depressive symptoms was significantly more. 17 % of them showed manic symptoms and among them mild symptoms was significantly more. On individual interview, none of the participants show mixed symptoms. So overall, around 64% of the participants with adult ADHD show mode symptoms either manic or depressive. Thus we strongly recommend to thoroughly screen the adult ADHD patients for other psychiatric illnesses including mood disorders.

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