Moodiness in ADHD by W. Burleson Daviss

Author:W. Burleson Daviss
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Risk and Etiological Factors

The estimated heritability of ADHD based on twin studies is 76% [14], while that of MDD is lower at 31–42% [15]. Individual risk factors for pediatric depressive disorders include female sex, and having other psychiatric disorders such as anxiety, oppositional, and conduct disorders [1, 4, 16]. ADHD and MDD share familial risk factors, and while both run in the same families, the predominant determinants of which ADHD patients go on to develop comorbid depressive disorders are more environmental than genetic [17]. Environmental risk factors for pediatric depressive disorders include exposure to traumatic life events, adverse family environments, family conflicts, and poor parental or peer relationships [1, 16]. Any lifetime history of comorbid depression among adolescents with ADHD has been associated with family conflict, negative life events, and trauma [12]. In children with ADHD, adverse family environments, poor parenting behaviors, and poor peer relationships are independent predictors of depressive symptoms [18]. Finally, interpersonal deficits have been shown to predict MDD persistence among youths with ADHD and MDD at outset [19].

Because the onset of depressive disorders typically is several years after that of ADHD, another potential environmental risk factor for developing Dep/ADHD could be pharmacotherapy for the ADHD. Stimulant medications, the most widely used treatment for ADHD, can occasionally cause dysphoric or labile moods [20, 21]. Moreover, two animal studies of young rodents have hinted that early stimulant exposure could increase the risk of developing comorbid depression in young humans [22, 23]. However, studies of humans with ADHD have more recently suggested that earlier ADHD pharmacotherapy [24] or any history of stimulant treatment [25] may reduce the risk of developing later MDD. Moreover, a recent population study has reported that patients with ADHD are more likely to attempt or complete suicide during periods when they are not taking their stimulant medication [26].

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