ADHD and Comorbid Conditions: If You Have ADHD, Chances Are You Have Something Else Too

Some people talk about ADHD being a “gift,” but I like to think of it more as a buy-one-get-one-free deal: if you have ADHD, there’s a good chance you have other psychiatric conditions to go along with it.

This year, a team of French researchers published some research they did to get a better sense of which conditions in particular are most likely to accompany ADHD. Their study looked at 81 adults with ADHD, screening for comorbid conditions including addiction, impulse control disorders and psychiatric disorders.

When they tallied up the results, they found that all three kinds of disorders were very common among the adults with ADHD — much more so than for the general population.

Most notably, two-thirds of the ADHD patients had some type of impulse control disorder. The prevalences of impulse control disorders were as follows:

  • Intermittent Explosive Disorder: 29.6 percent
  • Compulsive Buying: 23.4 percent
  • Pathological Gambling: 7.4 percent
  • Kleptomania: 2.4 percent
  • Compulsive Sexual Behavior: 2.4 percent
  • Trichotillomania: 1.2 percent

The idea that ADHD and impulse control disorders would go hand-in-hand makes sense when you remember that impulsivity is a hallmark of ADHD. But how frequent these disorders really are among adults with ADHD should be a wake-up call to how important treating ADHD is. The authors of the study note that ADHD is still dramatically underdiagnosed in France and that people with impulse control disorders should be considered for possible ADHD.

However, these aren’t the only comorbid conditions that are frequently layered on top of ADHD. Psychiatric disorders are also common:

  • Generalized anxiety disorder: 61.7 percent
  • Dysthymia: 44.4 percent
  • Major depressive episode: 28.7 percent
  • Agoraphobia: 22.2 percent
  • Panic disorder: 17.2 percent
  • Hypomanic episode: 16 percent
  • Social phobia: 11.1 percent
  • Bulimia nervosa: 8.6 percent
  • Antisocial personality disorder: 3.7 percent
  • Obsessive-compulsive disorder: 3.7 percent

In some cases, the stress of living with ADHD can exacerbate or even trigger some of these disorders. For example, it’s easy to see that having ADHD could snowball into having anxiety or depression (or both).

In other cases, there may simply be overlap in the biological mechanisms underlying these disorders (like genes). And many times, it’s a combination of both these things. A lot more research is going to have to be done for scientists to be able to say why ADHD so often doesn’t travel alone, but for now they do know that people with these disorders often have ADHD and vice-versa.

The study also looked at one other kind of condition: addiction. After all, when you combine a tendency to self-medicate with impulsivity, it’s not hard to see where things could be headed. The rates of addiction in the sample of adults with ADHD were:

  • Substance abuse (excluding alcohol): 14.8 percent
  • Alcohol abuse: 7.4 percent
  • Substance dependence (excluding alcohol): 6.1 percent
  • Alcohol dependence: 3.7 percent

Overall, it’s clear that people with ADHD are at higher risk for pretty much any kind of brain-related disorder you can name. In fact, they’re more likely than not to have comorbidites.

This is important because when people have ADHD along with one of these other conditions, the best way to treat that other condition is to also treat the ADHD. If you have ADHD and compulsive buying, for instance, it’s going to be harder to work on the compulsive buying if the ADHD goes undiagnosed. For the best results you have to cover all the bases — and, as research is showing, there’s a good chance that means at least two bases.

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