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Adults with BPD may have undiagnosed ADHD

In a major retrospective medical claims analysis at a medical meeting of child and adolescent psychiatrists, Shire plc announced that several adults with a depressive disorder, Bipolar Disorder (BPD) // , or an anxiety disorder might also have undiagnosed Attention-Deficit/Hyperactivity Disorder (ADHD)

Nearly 2.5% of the adults originally diagnosed with BPD were also diagnosed with ADHD within a year, during the period January 1, 2005 to December 31, 2005, as per the medical claims drawn from a large managed care database in the United States.

However, recent findings from the National Comorbidity Survey (NCS) showed that among adult patients surveyed ADHD existed comorbidly in 32.0 percent of those with a depressive disorder, 21.2 percent of those with BPD, and 9.5 percent of those with an anxiety disorder. When compared with these high overall levels of psychiatric comorbidity detected in the NCS, the low comorbid diagnosis rates of the medical claims analysis suggest that many adult patients with psychiatric disorders such as a depressive disorder, BPD or an anxiety disorder may also have undiagnosed ADHD.

"The large discrepancy between the known rates of ADHD comorbidity and the number of patients actually being diagnosed with comorbid ADHD clearly demonstrates that there is still a strong need for increased awareness of adult ADHD, and that physicians treating the adult population may benefit from additional training in evaluating and diagnosing this disorder," said Lenard A. Adler, M.D., lead researcher and director of the Adult ADHD Program in the Departments of Psychiatry and Neurology at New York University (NYU) School of Medicine and author of Scattered Minds: Hope and Help for Adults with ADHD (Putnam).

There are potentially serious consequences of ADHD in adults, including lower educational and occupational achievement, challenges with relationships, anti-social thoughts and poor self-esteem. "The NCS data sho w us that a fairly high proportion of adults with depressive, bipolar, or anxiety disorders may also suffer from ADHD, and evaluating adult patients for the symptoms of this disorder must become standard practice in the healthcare community," says Dr. Adler.

Researchers conducted a retrospective analysis on data from a 12-month period spanning January 1, 2005 through December 31, 2005 using medical claims derived from a large managed care database in the United States. All claims used in the analysis were from adult patients 18 years and older and no claims with the same diagnosis in the 6 months preceding the index date were used.

Throughout the period analyzed, patients were tracked for claims citing one or more of the other targeted conditions with a total of 900,897 new diagnoses of ADHD; 12,036,905 new diagnoses of a depressive disorder; 1,148,175 new diagnoses of BPD and 6,573,576 new diagnoses of anxiety disorders. Of those patients initially diagnosed with BPD, 2.5 percent were also diagnosed with ADHD and of those patients initially diagnosed with a depressive or anxiety disorder, 1.7 percent were also diagnosed with comorbid ADHD.


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