title: What do childhood attention deficit/hyperactivity symptoms in depressed adults tell us about the bipolar spectrum?
abstract: This study aims to establish if adult patients with major depressive disorder (MDD) and childhood Attention Deficit/Hyperactivity disorder (ADHD) symptoms would be more frequently within the bipolar spectrum than depressed patients without childhood ADHD.
  
  
  
  This study was carried out in outpatients recruited by psychiatrists in private practice, with 3963 participants being included in the final sample. Clinicians filled out questionnaires about current depressive symptoms in their patients, lifetime bipolar symptoms, global assessment of functioning and parental history of both major depression and bipolar disorder. Patients assessed current level of anxiety and depressive symptoms and antecedents of childhood ADHD symptoms.
  
  
  
  Depressed adults with significant childhood ADHD symptoms had a specific pattern of their major depressive episode compared to depressed patients without such symptoms. Subjects with childhood ADHD symptoms were more likely to report lifetime symptoms of mania/hypomania and to have a parent with type I or II bipolar disorder. The developmental trajectories of familial risk for lifetime bipolar symptoms showed that parental bipolar disorder influenced lifetime bipolar symptoms both through a direct pathway and an indirect pathway involving childhood ADHD symptoms. Childhood ADHD and number of depressive symptoms both made direct contributions to lifetime bipolar symptoms.
authors.affiliation: Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, Montpellier, France. Electronic address: d-purper_ouakil@chu-montpellier.fr.
authors.forename: D
authors.initials: D
authors.lastname: Purper-Ouakil
authors.affiliation: Unit of Child Neurology and Psychiatry of "Tor Vergata", University of Rome, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Porfirio
authors.affiliation: AP-HP Hôpital Louis Mourier, 178 Rue des Renouillers, 92700 Colombes, France; INSERM U894 Centre Psychiatrie et Neurosciences, Paris, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Le Strat
authors.affiliation: INSERM U1178, Maison de Solenn, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Falissard
authors.affiliation: INSERM U894 Centre Psychiatrie et Neurosciences, Paris, France; CMME Saint Anne Hospital, Hôpital Sainte-Anne (Paris-Descartes University), France.
authors.forename: P
authors.initials: P
authors.lastname: Gorwood
authors.affiliation: Stella Maris Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Masi
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000175:diagnosis*; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis*; D003865:Major Depressive Disorder / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010290:Parents; D011795:Surveys and Questionnaires; D063189:Symptom Assessment
keywords: Anxiety disorders; Attention deficit hyperactivity disorder; Bipolar disorder; Depressive disorder