Are patients with bipolar disorder and comorbid attention‐deficit hyperactivity disorder more neurocognitively impaired?

Torres, Imma; Solé, Brisa; Corrales, Montse; Jiménez, Esther; Rotger, Sofía; Serra-Pla, Juan F; Forcada, Irene; Richarte, Vanesa; Mora, Ester; Jacas, Carlos; Gómez, Núria; Mur, M.; Colom, Francesc; Casas, Miquel; Martínez-Àran, Anabel; Goikolea, José Manuel; Ramos-Quiroga, Josep Antoni

doi:10.1111/bdi.12540

Cited by 11 publications

(17 citation statements)

References 50 publications

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“…There are few previous studies in this area. Our finding of small overall cognitive differences between BD-cADHD and BD + cADHD is largely in agreement with the results of Torres and colleagues (Torres et al 2017) who found no significant differences between BD and BD + ADHD. Another study (Silva et al 2014) used only the Wisconsin Card Sorting Test and found that BD + ADHD showed set-shifting difficulties compared with ADHD and healthy controls.…”

Section: Discussionsupporting

confidence: 93%

“…The accuracy of retrospective self-reports of childhood symptoms has been questioned (Barkley et al 2002; Mannuzza et al 2002), and it is considered best practice to include multiple sources of information, e.g., a parental or next of kin interview (Davidson 2008). Furthermore, replication is needed given the limited sample size in the previous study (Torres et al 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Examining cognition in BD patients with and without comorbid ADHD might also serve to identify a BD subgroup with poor outcome in need for specific interventions. One study compared adults with BD, ADHD, BD + ADHD, and healthy controls across a broad spectrum of cognitive domains, but found no significant differences between BD and BD + ADHD (Torres et al 2017). However, the assessment of comorbid ADHD did not include any informant report.…”

Section: Introductionmentioning

confidence: 99%

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Neuropsychological profiles of adult bipolar disorder patients with and without comorbid attention-deficit hyperactivity disorder

Salarvan

Sparding

Clements

et al. 2019

Int J Bipolar Disord

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Background Comorbid attention-deficit/hyperactivity disorder (ADHD) is common in bipolar disorder and associated with worse outcomes. Cognitive testing might be a tool to identify this group. Here we compare the neuropsychological profiles of bipolar disorder patients with (BD + cADHD) and without (BD − cADHD) childhood attention-deficit hyperactivity disorder. Methods Adult patients with BD − cADHD (n = 66), BD + cADHD (n = 32), and healthy controls (n = 112) were tested using a comprehensive battery of neuropsychological tests. Patients underwent rigorous diagnostic assessments for bipolar disorder and ADHD, as well as a parental interview to establish childhood ADHD. Results The neuropsychological profiles of the groups were similar, except that the BD + cADHD group performed significantly worse on working memory. Working memory did not differ between those in the BD + cADHD group who only had a history of childhood ADHD and those that still met criteria for ADHD in adulthood. Conclusions Cognitive testing had limited power to differentiate between bipolar disorder adults with and without childhood ADHD. The BD + cADHD subgroup cannot explain the significant cognitive heterogeneity seen in bipolar disorder patients. Electronic supplementary material The online version of this article (10.1186/s40345-019-0149-9) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Neuropsychological profiles of adult bipolar disorder patients with and without comorbid attention-deficit hyperactivity disorder

Salarvan

Sparding

Clements

et al. 2019

Int J Bipolar Disord

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“…With one third, attention-deficit/hyperactivity disorder (ADHD) was the most frequent individual condition comorbid with BDspectrum disorders. This finding is consistent with some (Wingo and Ghaemi 2007;Torres et al 2017), but different from other studies conducted in adults where anxiety disorders (particularly panic attacks) were the most common comorbid diagnoses (Merikangas et al 2011).…”

Section: Comorbiditysupporting

confidence: 87%

Demographic and Clinical Characteristics, Including Subsyndromal Symptoms Across Bipolar-Spectrum Disorders in Adolescents

Pablo

Guinart

Cornblatt

et al. 2020

Journal of Child and Adolescent Psychopharmacology

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Objectives: Bipolar disorder (BD) is a debilitating illness that often starts at an early age. Prevention of first and subsequent mood episodes, which are usually preceded by a period characterized by subthreshold symptoms is important. We compared demographic and clinical characteristics including severity and duration of subsyndromal symptoms across adolescents with three different bipolar-spectrum disorders. Methods: Syndromal and subsyndromal psychopathology were assessed in adolescent inpatients (age = 12-18 years) with a clinical mood disorder diagnosis. Assessments included the validated Bipolar Prodrome Symptom Interview and Scale-Prospective (BPSS-P). We compared phenomenology across patients with a research consensus conference-confirmed DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) diagnoses of BD-I, BD-not otherwise specified (NOS), or mood disorder (MD) NOS. Results: Seventy-six adolescents (age = 15.6 -1.4 years, females = 59.2%) were included (BD-I = 24; BD-NOS = 29; MD-NOS = 23) in this study. Median baseline global assessment of functioning scale score was 21 (interquartile range = 17-40; between-group p = 0.31). Comorbidity was frequent, and similar across groups, including disruptive behavior disorders (55.5%, p = 0.27), anxiety disorders (40.8%, p = 0.98), and personality disorder traits (25.0%, p = 0.21). Mania symptoms (most frequent: irritability = 93.4%, p = 0.82) and depressive symptoms (most frequent: depressed mood = 81.6%, p = 0.14) were common in all three BD-spectrum groups. Manic and depressive symptoms were more severe in both BD-I and BD-NOS versus MD-NOS ( p < 0.0001). Median duration of subthreshold manic symptoms was shorter in MD-NOS versus BD-NOS (11.7 vs. 20.4 weeks, p = 0.002) and substantial in both groups. The most used psychotropics upon discharge were antipsychotics (65.8%; BD-I = 79.2%; BD-NOS = 62.1%; MD-NOS = 56.5%, p = 0.227), followed by mood stabilizers (43.4%; BD-I = 66.7%; BD-NOS = 31.0%; MD-NOS = 34.8%, p = 0.02) and antidepressants (19.7%; BD-I = 20.8%; BD-NOS = 10.3%; MD-NOS = 30.4%). Conclusions: Youth with BD-I, BD-NOS, and MD-NOS experience considerable symptomatology and are functionally impaired, with few differences observed in psychiatric comorbidity and clinical severity. Moreover, youth with BD-NOS and

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“…The present study had no control group of healthy individuals, and the cognitive data were adjusted for different variables (age, sex and education, according to the published reference values for the cognitive tests). Another limitation was related to the fact that participants included in this study were not screened for attention-deficit hyperactivity disorder (ADHD) and were thus not excluded, although a recent study reported that individuals with BD and ADHD showed the same cognitive performance as individuals with BD alone (Torres et al , 2017). The idea that there is a single consensus threshold to define impairment in clinical practice is questionable: a clinically significant cognitive deficit may rely on contextual factors such as premorbid ability.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of cognitive impairment in the euthymic phase of bipolar disorders: results from the FACE-BD cohort

et al. 2018

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Are patients with bipolar disorder and comorbid attention‐deficit hyperactivity disorder more neurocognitively impaired?

Abstract: Our results, although preliminary, suggest that the BD+ADHD group showed the same neurocognitive profile as pBD patients, most likely reflecting the same neurobiological basis. On the other hand, the pADHD group showed a more selective moderate impairment in attention.

Cited by 11 publications

References 50 publications

Neuropsychological profiles of adult bipolar disorder patients with and without comorbid attention-deficit hyperactivity disorder

Neuropsychological profiles of adult bipolar disorder patients with and without comorbid attention-deficit hyperactivity disorder

Demographic and Clinical Characteristics, Including Subsyndromal Symptoms Across Bipolar-Spectrum Disorders in Adolescents

Prevalence and determinants of cognitive impairment in the euthymic phase of bipolar disorders: results from the FACE-BD cohort

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