Bipolar disorder with comorbid attention‐deficit and hyperactivity disorder. Main clinical features and clues for an accurate diagnosis

Abstract

Adult patients with BD and ADHD show differential clinical features, but not a more severe course of BD. Comorbidity with substance abuse is a big issue, deserving special clinical attention. Better screening tools are necessary to avoid overdiagnosis of comorbid ADHD in BD.

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

“…BD subjects were recruited from a specialized program in the Bipolar Disorders Unit of the Hospital Clínic of Barcelona. These BD subjects had been previously screened for comorbidity with ADHD, and participants with a positive screening result were referred to the adult ADHD Program at the Hospital Universitari Vall d'Hebron Hospital (Barcelona) for thorough diagnostic assessment using the Conners' Adult ADHD Diagnostic Interview for DSM‐IV (CAADID) . This is a tertiary program for the assessment, diagnosis and comprehensive treatment of adult patients with suspected ADHD.…”

“…And only four of the 23 BD+ADHD patients were receiving pharmacological treatment for ADHD, according to the clinician`s clinical criteria. Further information about recruitment, assessment procedures for diagnosis and pharmacological treatments prescribed can be found in the clinical study by Torres et al …”

“…According to several clinical studies, 10%‐30% of adult patients with BD present comorbidity with lifetime ADHD . In these patients, the age of BD onset was earlier, and they showed differential clinical features, higher suicidality, and higher rates of comorbid substance use disorders . The neuropsychological features of patients with BD+ADHD have been poorly studied in adults.…”

Neurobiological support to the diagnosis of ADHD in stimulant‐naïve adults: pattern recognition analyses of MRI data

“…As we aimed to obtain diagnostic performance indices that could be related specifically to the inattention‐hyperactivity dimensions that characterize the ADHD diagnosis, we deliberately excluded individuals presenting major psychiatric comorbidities relatively common in adult ADHD patients, such as bipolar disorder . This strategy aimed to minimize the variability that would be potentially added to imaging measurements by such comorbidity.…”

Perseveration by NK1R-/- (‘knockout’) mice is blunted by doses of methylphenidate that affect neither other aspects of their cognitive performance nor the behaviour of wild-type mice in the 5-Choice Continuous Performance Test

“…For instance, there is evidence for an association between alcohol misuse and TACR1 polymorphism(s) (see Blaine et al, 2013), which could help explain why ADHD is a risk factor for co-morbid alcohol misuse (Wilens et al, 2011). Similarly, there is confirmed association between both TACR1 polymorphism(s) (Sklar et al, 2008; see Sharp et al, 2014) and ADHD (Torres et al, 2015) with bipolar disorder.…”