Original articleClinical and Diagnostic Implications of Lifetime Attention-Deficit/Hyperactivity Disorder Comorbidity in Adults with Bipolar Disorder: Data from the First 1000 STEP-BD Participants
Section snippets
Methods and Materials
The Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) is a multicenter National Institute of Mental Health-funded project designed to evaluate the longitudinal outcome of patients with bipolar disorder. The overall study combines a large, prospective, naturalistic study and a series of randomized controlled trials, which share a battery of common assessments (Sachs and Thase 2000). To enter STEP-BD, patients are required to be at least 15 years of age and to meet DSM-IV
Demographic and Diagnostic Characteristics
Participants in this study are the first consecutive 1000 participants in STEP-BD. Of the original 1000 patients, 81 were excluded from these analyses because of incomplete diagnostic data, resulting in a sample size of 919. Demographic and clinical characteristics are presented in Table 1. For the entire group, 41.6% were male, 92.6% were Caucasian, and the mean (SD) age at the time of evaluation was 40.58 (12.83) years. The proportions of the group diagnosed as bipolar I, II, and “other” were
Discussion
We found evidence of lifetime comorbid ADHD in approximately 9.5% (95% confidence interval 8%–11%) of our sample of 919 treatment-seeking adults with bipolar disorder, with 54 of 87 (62.1%) of those with lifetime ADHD meeting current criteria. An important gender difference exists, with 14.7% of male patients and 5.8% of female patients with comorbid lifetime ADHD. Consistent with previous studies that documented ADHD almost exclusively among patients with early-onset bipolar disorder, there
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