Behavioral, neurocognitive and treatment overlap between attention-deficit/hyperactivity disorder and mood instability

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a common and debilitating psychiatric disorder characterized by symptoms of inattention, impulsivity and motor restlessness. Consistently noted alongside these symptoms is mood instability in the form of irritability, volatility, swift changes in mood, hot temper and low frustration tolerance. The current diagnostic classification systems do not include mood instability as a core aspect of ADHD, but rather as an associated feature of the disorder. However, the literature suggests that overlapping cognitive deficits and neuroanatomical substrates may underlie both the classical ADHD symptoms and mood instability. Furthermore, common neurotherapeutic interventions in the form of stimulant medications or atomoxetine may help to alleviate both types of symptoms when they co-occur. This research suggests that mood instability and symptoms of ADHD may be interlinked and that mood instability may be better understood as a core feature of the ADHD syndrome.

Keywords::

• ADHD
• arousal
• atomoxetine
• emotion
• executive function
• methylphenidate
• mood
• neuropsychiatry

Acknowledgement

The authors thank Henrique Ludwig for his contribution to the study of mood instability in ADHD in the Maudsley Adult ADHD clinic.

Financial & competing interests disclosure

Philip Asherson is funded by two NIHR program grants for his work on ADHD (RP-PG-0606-1045 and RC-PG-0308-10245). He is in receipt of educational grants from Jannsen-Cilag for educatoinal programs on ADHD. He is paid consultancy and speaker fees from Jannsen-Cilag, Eli-Lilly, Shire and Flynn that are used to support reseach on adult ADHD The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.