Open AccessBipolar and ADHD Comorbidity: Both Artifact and Outgrowth of Shared Mechanisms
Author(s) -
Youngstrom Eric A.,
Arnold L. Eugene,
Frazier Thomas W.
Publication year - 2010
Publication title -
clinical psychology: science and practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 105
eISSN - 1468-2850
pISSN - 0969-5893
DOI - 10.1111/j.1468-2850.2010.01226.x
Subject(s) - comorbidity , categorization , mania , bipolar disorder , attention deficit hyperactivity disorder , psychology , psychiatry , clinical psychology , cognition , computer science , artificial intelligence
[Clin Psychol Sci Prac 17: 350–359, 2010] Published rates of comorbidity between pediatric bipolar disorder (PBD) and attention‐deficit/hyperactivity disorder (ADHD) have been higher than would be expected if they were independent conditions, but also dramatically different across different studies. This review examines processes that could artificially create the appearance of comorbidity or substantially bias estimates of the PBD‐ADHD comorbidity rate, including categorization of dimensional constructs, overlap among diagnostic criteria, over‐splitting, developmental sequencing, and referral or surveillance biases. Evidence also suggests some mechanisms for “true” PBD‐ADHD comorbidity, including shared risk factors, distinct subtypes, and weak causal relationships. Keys to differential diagnosis include focusing on episodic presentation and nonoverlapping symptoms unique to mania.