Prevalence and Clinical Impact of Attention-Deficit/Hyperactivity Disorder in inpatients with a primary diagnosis of an affective disorder: A Retrospective Study from a Specialized Inpatient Clinic

Prevalence and Clinical Impact of Attention-Deficit/Hyperactivity Disorder in inpatients with a primary diagnosis of an affective disorder: A Retrospective Study from a Specialized Inpatient Clinic | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and Clinical Impact of Attention-Deficit/Hyperactivity Disorder in inpatients with a primary diagnosis of an affective disorder: A Retrospective Study from a Specialized Inpatient Clinic Svenja Wudy, Nicole Mauche, Jue Huang, Christian Makiol, Maria Strauß This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8518298/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background It is well documented that attention deficit hyperactivity disorder (ADHD) and depression frequently co-occur. The objective of this study was to ascertain the prevalence of ADHD among patients admitted to a ward specializing in affective disorders. Methods Upon admission, each inpatient was required to complete an admission examination, which included the Adult ADHD Self-Report Scale (ASRS-v1.1). Those who met cut-off scores underwent a comprehensive ADHD assessment. Diagnostic data were collected encompassing sociodemographic, medical and psychiatric histories, and a psychopathological examination. Results 58 patients (41.1%) screened positive on the ASRS v1.1 Part A, and 15 (10.6%) met full diagnostic criteria following detailed assessment and sufficient remission of depressive symptoms. Among the 83 ASRS-negative patients, 18 (12.7%) were referred for further evaluation due to anamnestic indicators, resulting in 13 additional clinically confirmed cases (9.2%). The resulting ADHD prevalence was 10.6% based on the structured protocol and 19.9% when clinically judged cases were included. Limitations The findings are limited by the small and specialized inpatient sample, potentially restricting generalizability. ADHD diagnoses were established during depressive episodes, so mood-related diagnostic bias cannot be fully excluded. Conclusions Considering comorbid ADHD in depression is of particular importance. ADHD screening instruments are valuable for identifying ADHD in depressed patients. Furthermore, the results of our study indicate that a rapid onset of depression, as measured by the ODI, may signal hidden ADHD. Recognizing comorbid ADHD has significant clinical implications, influencing both diagnosis and treatment, which can be a game changer in patient outcomes. ADHD major depression screening prevalence onset of depression Full Text Additional Declarations Competing interest reported. M.S. has received speaker’s fees from Medice, Takeda, Janssen and was an advisory board member for Takeda, Janssen and Medice in the past 3 years. The other authors do not report any possible conflicts of interest. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 23 Feb, 2026 Reviews received at journal 19 Feb, 2026 Reviewers agreed at journal 09 Feb, 2026 Reviewers invited by journal 09 Feb, 2026 Editor invited by journal 14 Jan, 2026 Editor assigned by journal 12 Jan, 2026 Submission checks completed at journal 12 Jan, 2026 First submitted to journal 05 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8518298","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":607744570,"identity":"3316a18b-d744-43bc-9bb5-bcc79a9eedd7","order_by":0,"name":"Svenja Wudy","email":"data:image/png;base64,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","orcid":"","institution":"University Hospital of Leipzig","correspondingAuthor":true,"prefix":"","firstName":"Svenja","middleName":"","lastName":"Wudy","suffix":""},{"id":607744571,"identity":"7480e639-3158-4fc1-9996-5dd6a2c0a024","order_by":1,"name":"Nicole Mauche","email":"","orcid":"","institution":"Leipzig University","correspondingAuthor":false,"prefix":"","firstName":"Nicole","middleName":"","lastName":"Mauche","suffix":""},{"id":607744572,"identity":"28714c50-4e1e-44ec-a20d-c1865007ab39","order_by":2,"name":"Jue Huang","email":"","orcid":"","institution":"Leipzig University","correspondingAuthor":false,"prefix":"","firstName":"Jue","middleName":"","lastName":"Huang","suffix":""},{"id":607744573,"identity":"5d4c4a58-63ab-4b47-976e-09d57a82ab8b","order_by":3,"name":"Christian Makiol","email":"","orcid":"","institution":"Leipzig University","correspondingAuthor":false,"prefix":"","firstName":"Christian","middleName":"","lastName":"Makiol","suffix":""},{"id":607744575,"identity":"6d99f861-a87d-4112-ad2e-b6476c1f2d18","order_by":4,"name":"Maria Strauß","email":"","orcid":"","institution":"University Hospital of Leipzig","correspondingAuthor":false,"prefix":"","firstName":"Maria","middleName":"","lastName":"Strauß","suffix":""}],"badges":[],"createdAt":"2026-01-05 07:39:29","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8518298/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8518298/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105414058,"identity":"e4453346-14a6-49c2-bf73-2d229897a25a","added_by":"auto","created_at":"2026-03-25 18:10:20","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":668855,"visible":true,"origin":"","legend":"","description":"","filename":"ADHDSCREENINGFulltextJHMSBMCtechnicalcheck.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8518298/v1_covered_05e3e4a5-1a53-463c-b347-cb50fb52b770.pdf"}],"financialInterests":"Competing interest reported. M.S. has received speaker’s fees from Medice, Takeda, Janssen and was an advisory board member for Takeda, Janssen and Medice in the past 3 years. \nThe other authors do not report any possible conflicts of interest.","formattedTitle":"Prevalence and Clinical Impact of Attention-Deficit/Hyperactivity Disorder in inpatients with a primary diagnosis of an affective disorder: A Retrospective Study from a Specialized Inpatient Clinic","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"ADHD, major depression, screening, prevalence, onset of depression ","lastPublishedDoi":"10.21203/rs.3.rs-8518298/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8518298/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIt is well documented that attention deficit hyperactivity disorder (ADHD) and depression frequently co-occur. The objective of this study was to ascertain the prevalence of ADHD among patients admitted to a ward specializing in affective disorders.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUpon admission, each inpatient was required to complete an admission examination, which included the Adult ADHD Self-Report Scale (ASRS-v1.1). Those who met cut-off scores underwent a comprehensive ADHD assessment. Diagnostic data were collected encompassing sociodemographic, medical and psychiatric histories, and a psychopathological examination.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e58 patients (41.1%) screened positive on the ASRS v1.1 Part A, and 15 (10.6%) met full diagnostic criteria following detailed assessment and sufficient remission of depressive symptoms. Among the 83 ASRS-negative patients, 18 (12.7%) were referred for further evaluation due to anamnestic indicators, resulting in 13 additional clinically confirmed cases (9.2%). The resulting ADHD prevalence was 10.6% based on the structured protocol and 19.9% when clinically judged cases were included.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe findings are limited by the small and specialized inpatient sample, potentially restricting generalizability. ADHD diagnoses were established during depressive episodes, so mood-related diagnostic bias cannot be fully excluded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConsidering comorbid ADHD in depression is of particular importance. ADHD screening instruments are valuable for identifying ADHD in depressed patients. Furthermore, the results of our study indicate that a rapid onset of depression, as measured by the ODI, may signal hidden ADHD. Recognizing comorbid ADHD has significant clinical implications, influencing both diagnosis and treatment, which can be a game changer in patient outcomes.\u003c/p\u003e","manuscriptTitle":"Prevalence and Clinical Impact of Attention-Deficit/Hyperactivity Disorder in inpatients with a primary diagnosis of an affective disorder: A Retrospective Study from a Specialized Inpatient Clinic","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-25 18:09:09","doi":"10.21203/rs.3.rs-8518298/v1","editorialEvents":[{"type":"communityComments","content":1},{"type":"reviewerAgreed","content":"168920155428426303789558345414196045829","date":"2026-02-23T12:33:34+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-19T09:38:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"174379438559350367633583322955936077632","date":"2026-02-09T16:37:17+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-09T13:02:25+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-14T14:42:32+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-13T02:34:44+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-13T02:34:31+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychiatry","date":"2026-01-05T07:20:28+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"64a0a8b5-8f03-4ee3-a6f6-06d72ae353aa","owner":[],"postedDate":"March 25th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-25T18:09:09+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-25 18:09:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8518298","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8518298","identity":"rs-8518298","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}