Attention-deficit hyperactivity disorder -- bipolar comorbidity in children and adolescents.

Abstract

OBJECTIVE:

A substantial portion of juvenile bipolar disorder (BD) has a comorbid attention-deficit hyperactivity disorder (ADHD). The aim of our study was to analyze the cross-sectional and longitudinal implications of such comorbidity in children and adolescents with BD.

METHODS:

Ninety-eight refereed patients (mean age 13.7 +/- 3.0 years) with a diagnosis of BD by the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime version (K-SADS-PL) were followed for 6 months.

RESULTS:

Thirty-seven BD patients (37.8%) presented a lifetime diagnosis of comorbid ADHD. The mean age of onset of ADHD was 3.7 +/- 1.1 years, and the mean age of onset of BD was 10.0 +/- 3.2 years. Bipolar subjects with comorbid ADHD were predominantly male, younger, and had an earlier onset of BD (8.1 +/- 2.8 versus 11.1 +/- 2.9 years). Bipolar-ADHD patients presented more frequently a chronic rather than an episodic course of BD, with an irritable rather than an elated mood. They showed higher rates of oppositional defiant disorder/conduct disorder, lower rates of panic disorder, and less frequently received antidepressant medications. Finally, ADHD comorbidity was associated with a greater psychosocial impairment.

CONCLUSIONS:

ADHD comorbidity is frequent in juvenile BD and can influence age of onset, phenomenology, comorbidity, and course of BD. A timely diagnosis should improve our efforts regarding the outcome of these subjects.

• Authors: Gabriele Masi, Giulio Perugi, Cristina Toni, Stefania Millepiedi, Maria Mucci, Nicoletta Bertini, Chiara Pfanner
• Journal: Bipolar disorders (Bipolar Disord) Vol. 8 Issue 4 Pg. 373-81 (Aug 2006) ISSN: 1398-5647 [Print] Denmark
• PMID: 16879138 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antipsychotic Agents

Topics

• Adolescent
• Age of Onset
• Antipsychotic Agents (therapeutic use)
• Attention Deficit Disorder with Hyperactivity (drug therapy, epidemiology)
• Bipolar Disorder (drug therapy, epidemiology)
• Chi-Square Distribution
• Child
• Comorbidity
• Diagnostic and Statistical Manual of Mental Disorders
• Female
• Humans
• Interview, Psychological
• Longitudinal Studies
• Male
• Psychiatric Status Rating Scales (statistics & numerical data)