Attention-deficit hyperactivity disorder comorbidity and antidepressant resistance among patients with major depression: A nationwide longitudinal study.
The comorbidity between attention deficit hyperactivity disorder (ADHD) and major depression is common. However, the influence of ADHD comorbidity in the response or resistance to antidepressants remains unknown among patients with major depression. 1891 patients with major depression and ADHD and 1891 age-/sex-matched patients with major depression only were enrolled and followed for 1 year in our study. Use of antidepressants and ADHD medications during 1-year follow-up period were assessed. Antidepressant resistance was defined as treatment failure in two or more than two different antidepressants for adequate treatment dose and duration. Patients with major depression and ADHD had an increased risk of treatment resistance to antidepressants (odds ratio [OR]: 2.32, 95% confidence interval [CI]: 1.63-3.32) compared with patients with major depression only after adjusting for demographic characteristics and other psychiatric comorbidities. Regular treatment for ADHD would reduce this risk (OR: 1.76, 95% CI: 0.72-4.27). Anxiety (OR: 3.15, 95% CI: 2.24-4.44) and substance use (OR: 2.45, 95% CI: 1.16-5.17) disorders were also associated with an elevated likelihood of resistance to antidepressants during the follow-up. Patients who had dual diagnoses of major depression and ADHD were more likely to have treatment resistance to antidepressants compared with patients with major depression only. Prompt and regular treatment for ADHD would reduce this risk.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
Mu-Hong
MH
Chen
School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan; Liver Research Center, Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Tai-Long
TL
Pan
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: jwhsu@vghtpe.gov.tw.
Ju-Wei
JW
Hsu
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
Kai-Lin
KL
Huang
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
Tung-Ping
TP
Su
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
Cheng-Ta
CT
Li
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
Wei-Chen
WC
Lin
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
Shih-Jen
SJ
Tsai
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Wen-Han
WH
Chang
Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
Tzeng-Ji
TJ
Chen
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: ymbi@mail2000.com.tw.
Ya-Mei
YM
Bai
D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D002648:Child; D003865:Major Depressive Disorder / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D061218:Depressive Disorder, Treatment-Resistant / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D012307:Risk Factors; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
D000928:Antidepressive Agents
ADHD; Antidepressant resistance; Major depression