2024-01-26 19:28:29
Cyclothymic disorders are common in the general population. They fall into the spectrum of bipolar disorders and are defined by the regular presence for at least 2 years of symptoms of hypomania and depression which last for a few days. Other behavioral disorders are also associated with it, such as mood changes, impulsivity or anxiety. Emotional dysregulation in particular is a central element of these disorders, as it is for ADHD. These two disorders share many points of similarity and are often associated with other psychiatric comorbidities, which complicates their diagnosis and management. In a preliminary study carried out on a hundred cyclothymic patients, an Italian team looked for the presence of ADHD and analyzed the clinical and sociodemographic parameters associated with the presence or absence of these disorders.
High prevalence of ADHD in cyclothymic subjects
Study participants were recruited from a psychiatric department at the University Hospital of Pisa (Italy) (n=107, 80% women, average age 35 years). The presence of ADHD was assessed using the Adult ADHD Self-Assessment Scale (Adult ADHD Self-Report Scale, ASRS) and the clinical and sociodemographic parameters recorded.
ADHD might thus be identified in 43% of the patients included. These ADHD+ subjects were younger overall and had a lower level of education compared to the cyclothymic ADHD- subjects.
Psychiatric comorbidities and character traits of ADHD subjects
Psychiatric comorbidities were present in 75% of participants, but more frequent in ADHD+ subjects. In particular, eating disorders, mainly bulimia and eating compulsions, were twice as frequent as in subjects without ADHD.
Family history of ADHD and alcohol use disorders were more often found in this group of patients, as were problems with emotional dysregulation. In particular, emotional instability, emotional impulsivity and negative emotions were more frequent. These subjects also had higher scores on the depression and cyclothymia sections of the TIME-M temperament self-questionnaire, as well as a greater propensity for irritability and anxiety. In multivariate analysis, affective instability and psychiatric comorbidities were the most differentiating parameters between ADHD+ and ADHD- subjects.
These results are, however, limited by the small sample size and the cross-sectional nature of the study.
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