Comorbidity between attention deficit hyperactivity disorder (ADHD) and bipolar disorder in a specialized mood disorders outpatient clinic

Perroud, Nader; Cordera, Paolo; Zimmermann, Julien; Michalopoulos, Giorgio; Bancila, Victor; Prada, Paco; Dayer, Alexandre; Aubry, Jean‐Michel

doi:10.1016/j.jad.2014.06.053

Cited by 61 publications

(67 citation statements)

References 27 publications

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“…Recent work suggests ADHD may increase risk for substance use problems in the absence of BD (Bidwell et al 2014; Kolla et al 2016; Urcelay and Dalley 2012) and when comorbid with BD (Perroud et al 2014). The neuroanatomical factors underlying this association are unclear.…”

Section: Discussionmentioning

confidence: 99%

Brain circuitry associated with the development of substance use in bipolar disorder and preliminary evidence for sexual dimorphism in adolescents

Lippard

Mazure

Johnston

et al. 2016

J of Neuroscience Research

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Substance use disorders (SUDs) and mood disorders are highly comorbid and confer a high risk for adverse outcomes. However, data are limited on the neurodevelopmental basis of this comorbidity. Substance use initiation typically occurs during adolescence and sex-specific developmental mechanisms are implicated. In this preliminary study we review the literature and investigate regional gray matter volume (GMV) associated with subsequent substance use problems in adolescents with bipolar disorder (BD) and explore these associations for females and males. Thirty DSM-IV diagnosed BD adolescents with minimal alcohol/substance exposure completed baseline structural magnetic resonance imaging scans. At follow-up (on average 6 years post-baseline), subjects were administered the CRAFFT interview and categorized into those scoring at high (>2: CRAFFTHIGH) versus low (<2: CRAFFTLOW) risk for alcohol/substance problems. Lower GMV in prefrontal, insular, and temporopolar cortices were observed at baseline among adolescents with BD reporting subsequent alcohol and cannabis use compared to adolescents with BD who did not (p<0.005, clusters >20 voxels). Lower dorsolateral prefrontal GMV was associated with future substance use in both females and males. In females, lower orbitofrontal and insula GMV was associated with future substance use; while in males, lower rostral prefrontal GMV was associated with future use. Lower orbitofrontal, insular and temporopolar GMV was observed in those who transitioned to smoking tobacco. Findings indicate GMV development is associated with risk for future substance use problems in adolescents with BD, with results implicating GMV development in regions subserving emotional regulation in females and regions subserving executive processes and attention in males.

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Section: Discussionmentioning

confidence: 99%

Brain circuitry associated with the development of substance use in bipolar disorder and preliminary evidence for sexual dimorphism in adolescents

Lippard

Mazure

Johnston

et al. 2016

J of Neuroscience Research

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“…An earlier age at onset of BD symptoms is associated with a more severe course of illness (Coryell et al, 2013; Oostervink et al, 2015; Suominen et al, 2007). Similarly, ADHD is highly comorbid with BD (Karaahmet et al, 2013; Perroud et al, 2014), and the presence of ADHD symptoms in childhood is associated with an earlier age of onset of BD (Jerrell et al, 2014; Wozniak et al, 1995) and a poor prognosis (Asherson et al, 2014). BD is also associated with heightened levels of aggression (Ballester et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Factor analysis of temperament and personality traits in bipolar patients: Correlates with comorbidity and disorder severity

Qiu

Akiskal

Kelsoe

et al. 2017

Journal of Affective Disorders

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Background Temperament and personality traits have been suggested as endophenotypes for bipolar disorder based on several lines of evidence, including heritability. Previous work suggested an anxious-reactive factor identified across temperament and personality inventories that produced significant group discrimination and could potentially be useful in genetic analyses. We have attempted to further characterize this factor structure in a sample of bipolar patients. Methods A sample of 1195 subjects with bipolar I disorder was evaluated, all with complete data available. Dimension reduction across two inventories identified 18 factors explaining 39% of the variance. Results The two largest factors reflected affective instability and general anxiety/worry, respectively. Subsequent analyses of the clinical features associated with bipolar disorder revealed specificity for the factors in a predictable pattern. Cluster analysis of the factors identified a subgroup defined by a strong lack of general anxiety and low affective instability represented by the first two factors. The remaining subjects could be distinguished into two clusters by the presence of either more positive characteristics, including persistence/drive, spirituality, expressivity, and humor, or more negative characteristics of depression and anxiety. Limitations These analyses involved bipolar I subjects only and must be extended to other bipolar spectrum diagnoses, unaffected relatives, and individuals at risk. Conclusions These results suggest that temperament and personality measures access latent traits associated with important clinical features of bipolar disorder. By translating clinical variables into quantitative traits, we may identify subgroups of bipolar patients with distinct clinical profiles, thereby facilitating both individual treatment strategies and genetic analyses.

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“…Likewise about the same proportion of adult BP patients meet the criteria for ADHD (Perroud et al 2014). BPD patients with ADHD tend to have greater levels of other co-morbidities, for example anxiety, depression, substance use, childhood traumas and EUPD.…”

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confidence: 98%

“…Unfortunately, these first presentations are commonly dismissed as just drug induced episodes and the opportunity to intervene early in BPD is lost. Comorbidities are associated with longer delays in accessing treatment and poorer prognosis (Strakowski et al 2000;Leboyer et al 2005;Perroud et al 2014).…”

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confidence: 99%

“…They also have worse outcomes and poorer treatment response. ADHD screening measures are unreliable in this population and diagnosis should be left to psychiatrists with clinical expertise in these conditions (Perroud et al 2014). In children, ADHD and manic symptoms are very similar but one important distinction is whether they are episodic (Leibenluft & Dickstein, 2008).…”

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confidence: 99%

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Intervening early in bipolar disorder in young people: a review of the clinical staging model

Power

2015

Ir. j. psychol. Med.

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Bipolar disorder (BPD) essentially has its onset during adolescence and early adulthood. It has the capacity to be highly disruptive, dislocating individuals from their normal developmental trajectory and potentially causing significant long-term co-morbidity and chronicity. At a societal level the burden created is greater than schizophrenia. This is not helped by the very substantial delays in its diagnosis and appropriate treatment. Thus, there is a clear rationale for intervening earlier and at a younger age. However, the field of early intervention in BPD is in its infancy. One approach that conceptually provides a basis for early intervention is the Clinical Staging Model (used widely in general medicine). This article outlines how this model helps in an understanding of the emerging stages of BPD. It also summarises the interventions that might be appropriately introduced if a person progresses from an early to a late stage of the illness. Early intervention has a well-established record in psychotic disorders. If it can be realised for BPDs, then it may hold out hope of better outcomes for the next generation of young people at risk.

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Comorbidity between attention deficit hyperactivity disorder (ADHD) and bipolar disorder in a specialized mood disorders outpatient clinic

Cited by 61 publications

References 27 publications

Brain circuitry associated with the development of substance use in bipolar disorder and preliminary evidence for sexual dimorphism in adolescents

Brain circuitry associated with the development of substance use in bipolar disorder and preliminary evidence for sexual dimorphism in adolescents

Factor analysis of temperament and personality traits in bipolar patients: Correlates with comorbidity and disorder severity

Intervening early in bipolar disorder in young people: a review of the clinical staging model

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