title: Higher risk of mood disorders among adolescents with ADHD and asthma: a nationwide prospective study.
abstract: BACKGROUND
  Attention-deficit hyperactivity disorder (ADHD) and asthma are commonly comorbid together, and are associated with an increased risk of development of mood disorders separately. However, there has been no study investigating the comorbid effect of these two disorders on developing mood disorder.
  
  
  METHODS
  Using the National Health Insurance Research Database, adolescents with ADHD-alone, asthma-alone, ADHD comorbid with asthma, and age-/gender-matched (1:4) controls were recruited in 2003. Subjects who developed major depression, any depressive disorder, or bipolar disorder during the follow-up period (2003-2010) were identified.
  
  
  RESULTS
  In all, 1172 adolescents with ADHD-alone, 487 with asthma-alone, 238 with ADHD+asthma, and 7552 controls were recruited in 2003. Adolescents with ADHD+asthma and those with ADHD-alone, but not those with asthma-alone, had an elevated risk of developing major depression (hazard ratio [HR]: 10.25, 95% confidence interval [CI]: 3.86-27.19; HR: 8.64, 95%CI: 5.00-14.93; HR: 2.11, 95%CI: 0.71-6.23) and bipolar disorder (HR: 31.25, 95%CI: 8.87-110.12; HR: 10.42, 95%CI: 4.60-23.63; HR: 1.91, 95%CI: 0.24-15.32) compared to the control group.
  
  
  CONCLUSIONS
  Our results showed that ADHD adolescents had an increased risk of developing both unipolar depression and bipolar depression in their later life, and that the comorbidity of asthma with a synergistic effect increased this risk further. The underlying pathophysiology among ADHD, asthma, and mood disorders needs further investigation.
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Mu-Hong
authors.initials: MH
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tung-Ping
authors.initials: TP
authors.lastname: Su
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ying-Sheue
authors.initials: YS
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ju-Wei
authors.initials: JW
authors.lastname: Hsu
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Kai-Lin
authors.initials: KL
authors.lastname: Huang
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Wen-Han
authors.initials: WH
authors.lastname: Chang
authors.affiliation: Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan. Electronic address: ymbi@mail2000.com.tw.
authors.forename: Ya-Mei
authors.initials: YM
authors.lastname: Bai
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology*; D011446:Prospective Studies; D013624:Taiwan / Q000453:epidemiology
keywords: ADHD; Asthma; Bipolar disorder; Depression