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Pediatric bipolar spectrum disorder and ADHD: comparison and comorbidity in the LAMS clinical sample
Author(s) -
Arnold L Eugene,
Demeter Christine,
Mount Katherine,
Frazier Thomas W,
Youngstrom Eric A,
Fristad Mary,
Birmaher Boris,
Findling Robert L,
Horwitz Sarah M,
Kowatch Robert,
Axelson David A
Publication year - 2011
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/j.1399-5618.2011.00948.x
Subject(s) - comorbidity , bipolar disorder , psychiatry , attention deficit hyperactivity disorder , psychology , mood disorders , mood , clinical psychology , pediatrics , medicine , anxiety
Arnold LE, Demeter C, Mount K, Frazier TW, Youngstrom EA, Fristad M, Birmaher B, Findling RL, Horwitz SM, Kowatch R, Axelson DA. Pediatric bipolar spectrum disorder and ADHD: comparison and comorbidity in the LAMS clinical sample. Bipolar Disord 2011: 13: 509–521. © 2011 The Authors. Journal compilation © 2011 John Wiley & Sons A/S. Objective: To compare attention‐deficit hyperactivity disorder (ADHD), bipolar spectrum disorders (BPSDs), and comorbidity in the Longitudinal Assessment of Manic Symptoms (LAMS) study. Methods: Children ages 6–12 were recruited at first visit to clinics associated with four universities. A BPSD diagnosis required that the patient exhibit episodes. Four hypotheses were tested: (i) children with BPSD + ADHD would have a younger age of mood symptom onset than those with BPSD but no ADHD; (ii) children with BPSD + ADHD would have more severe ADHD and BPSD symptoms than those with only one disorder; (iii) global functioning would be more impaired in children with ADHD + BPSD than in children with either diagnosis alone; and (iv) the ADHD + BPSD group would have more additional diagnoses. Results: Of 707 children, 421 had ADHD alone, 45 had BPSD alone, 117 had both ADHD and BPSD, and 124 had neither. Comorbidity (16.5%) was slightly less than expected by chance (17.5%). Age of mood symptom onset was not different between the BPSD + ADHD group and the BPSD‐alone group. Symptom severity increased and global functioning decreased with comorbidity. Comorbidity with other disorders was highest for the ADHD + BPSD group, but higher for the ADHD‐alone than the BPSD‐alone group. Children with BPSD were four times as likely to be hospitalized (22%) as children with ADHD alone. Conclusions: The high rate of BPSD in ADHD reported by some authors may be better explained as a high rate of both disorders in child outpatient settings rather than ADHD being a risk factor for BPSD. Co‐occurrence of the two disorders is associated with poorer global functioning, greater symptom severity, and more additional comorbidity than for either single disorder.