Affective Temperaments Misdiagnosed as Adult Attention Deficit Disorder: Prevalence and Treatment Effects

• Published in: The journal of nervous and mental disease Vol. 211; no. 7; p. 504
• Main Authors: Mauer, Sivan, Ghazarian, Garo, Ghaemi, S Nassir
• Format: Journal Article
• Language: English
• Published: United States 01.07.2023
• Subjects: Adult; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - drug therapy; Attention Deficit Disorder with Hyperactivity - epidemiology; Bipolar Disorder - psychology; Cyclothymic Disorder - diagnosis; Cyclothymic Disorder - epidemiology; Cyclothymic Disorder - psychology; Humans; Personality Inventory; Prevalence; Surveys and Questionnaires; Temperament
• ISSN: 1539-736X
• DOI: 10.1097/NMD.0000000000001626

Adult attention-deficit disorder (ADD) is a common diagnosis, and amphetamine medications are increasingly used. Recent reports suggest high prevalence of affective temperaments, such as cyclothymia, in adult ADD. This study reexamines prevalence rates as reflecting misdiagnosis and reports for the first time on the effects of amphetamine medications on mood/anxiety and cognition in relation to affective temperaments. Among outpatients treated at the Tufts Medical Center Mood Disorders Program (2008-2017), 87 cases treated with amphetamines were identified, versus 163 non-amphetamine-treated control subjects. Using the Temperament Scale of Memphis, Pisa, Paris and San Diego-Autoquestionnaire, 62% had an affective temperament, most commonly cyclothymia (42%). In amphetamine-treated cases, mood/anxiety symptoms worsened notably in 27% ( vs. 4% in the control group, risk ratio [RR] 6.2, confidence interval [CI], 2.8-13.8), whereas 24% had moderate improvement in cognition ( vs. 6% in the control group; RR, 3.93; CI, 1.9-8.0). Affective temperaments, especially cyclothymia, are present in persons about one-half of persons diagnosed with adult ADD and/or treated with amphetamines.