Service Evaluation of Treatment Response in Adult ADHD Patients With Psychiatric Comorbidities

AIMS: To assess whether psychiatric comorbidities affect response to medications in adulthood ADHD. METHODS: This study included 236 subjects diagnosed with ADHD in adulthood between the ages of 18 and 65 years and receiving pharmacological treatment for the same across community treatment teams in Durham and Darlington. Patients were identified by going through electronic case notes. Review of SWMWEBS scores and clinic letters were carried out both prior to and following commencing medication for ADHD to assess response to treatment. Comorbidities were recorded by reviewing clinic letters. RESULTS: 56% of the study subjects had no psychiatric comorbidity while 44% had at least one comorbid psychiatric diagnosis. Both groups had a higher prevalence of males in the ratio of 1.9:1(with comorbidities) and 3:1 (without comorbidities). Depression(56%) was noted to be the most common comorbidity followed by Autism(22%), Emotionally Unstable Personality Disorder(11%) and Bipolar Affective Disorder(10%). 94% patients without comorbidities responded favourably to treatment whereas only 56% of patients with comorbidities improved with treatment. CONCLUSION: Having a comorbid psychiatric illness is likely to negatively impact both treatment response and recovery in adults with ADHD. Both groups(with and without comorbidities) had a male predominance (2.5:1). Higher number of patients amongst the nil comorbidities group responded favourably to treatment. Most common psychiatric comorbidity was Depression. Least favourable response to treatment was found among the groups of Emotionally Unstable Personality Disorder and Bipolar Affective Disorder. No gender bias in response to treatment across both the groups.