Comorbidity Between ADHD and Symptoms of Bipolar Disorder in a Community Sample of Children and Adolescents

AbstractThe prevalence and frequency of comorbidity of possible bipolar disorder was examined with attention-deficit hyperactivity disorder (ADHD) in a nonreferred population of twins. Children and adolescents aged 7 to 18 years with a history of manic symptoms were identified from a population-based twin sample obtained from state birth records (n = 1610). The sample was enriched for ADHD; however, there was also a random control sample (n = 466), which allowed a look at the population prevalence of the disorder. Juveniles with threshold or below threshold manic episodes were further assessed for comorbidity with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) and population-defined ADHD subtypes (from latent class analysis) using Fisher's exact test. Nine juveniles who exhibited DSM-IV manic (n = 1), hypomanic (n = 2) or below threshold episodes (n = 6) were identified. The population prevalence of broadly defined mania in the random sample was 0.2%. The possible manic episodes showed significant comorbidity with population-defined severe combined and talkative ADHD subtypes. It can be concluded that there is a significant association of bipolar symptoms with two population-defined subtypes of ADHD. Episodes of possible bipolar disorders as defined by DSM-IV are uncommon in this nonreferred sample. Children and adolescents with ADHD appear to be only modestly at increased risk for bipolar disorders.

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Deficits in explicit emotion regulation in bipolar disorder: a systematic review

International Journal of Bipolar Disorders ◽

10.1186/s40345-021-00221-9 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Marcel Kurtz ◽

Pia Mohring ◽

Katharina Förster ◽

Michael Bauer ◽

Philipp Kanske

Keyword(s):

At Risk ◽

Bipolar Disorder ◽

Emotion Regulation ◽

Mood State ◽

Bipolar Disorders ◽

Protective Measure ◽

Behavioral Measures ◽

Increased Risk ◽

Regulation Strategies ◽

Depressive Episodes

Abstract Background This study aimed to compile and synthesize studies investigating explicit emotion regulation in patients with bipolar disorder and individuals at risk of developing bipolar disorder. The importance of explicit emotion regulation arises from its potential role as a marker for bipolar disorders in individuals at risk and its potent role in therapy for bipolar disorder patients. Methods To obtain an exhaustive compilation of studies dealing specifically with explicit emotion regulation in bipolar disorder, we conducted a systematic literature search in four databases. In the 15 studies we included in our review, the emotion-regulation strategies maintenance, distraction, and reappraisal (self-focused and situation-focused) were investigated partly on a purely behavioral level and partly in conjunction with neural measures. The samples used in the identified studies included individuals at increased risk of bipolar disorder, patients with current affective episodes, and patients with euthymic mood state. Results In summary, the reviewed studies' results indicate impairments in explicit emotion regulation in individuals at risk for bipolar disorder, patients with manic and depressive episodes, and euthymic patients. These deficits manifest in subjective behavioral measures as well as in neural aberrations. Further, our review reveals a discrepancy between behavioral and neural findings regarding explicit emotion regulation in individuals at risk for bipolar disorders and euthymic patients. While these groups often do not differ significantly in behavioral measures from healthy and low-risk individuals, neural differences are mainly found in frontostriatal networks. Conclusion We conclude that these neural aberrations are a potentially sensitive measure of the probability of occurrence and recurrence of symptoms of bipolar disorders and that strengthening this frontostriatal route is a potentially protective measure for individuals at risk and patients who have bipolar disorders.

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Bipolar Type I Disorder in Children

Archives of The Medicine and Case Reports ◽

10.37275/amcr.v1i1.2 ◽

2020 ◽

Vol 1 (1) ◽

pp. 11-14

Author(s):

Syaiful Fadilah ◽

Fatimah Haniman

Keyword(s):

Bipolar Disorder ◽

Children And Adolescents ◽

Severe Disease ◽

Large Population ◽

Type I ◽

Disease Course ◽

Clinical Area ◽

Clinical Disorder ◽

Bipolar Type ◽

Dsm Iv

Bipolar disorder in children and adolescents is a clinical disorder that causes publicmental health problems that need attention. In the last decade, bipolar disorder in children andadolescents has become a trendy field, both in the clinical area and in research, especially interms of diagnosis, which is still controversial. The controversy that remains is whether it ispossible to diagnose bipolar disorder in prepubertal children. Based on the DSM-IV-TRdiagnostic criteria, the prevalence of the bipolar disorder in children scarce rare.Epidemiological studies report the lifetime prevalence of bipolar I and II disorders in lateadolescence is about 1 per cent. Various studies in a large population have shown aprevalence rate of 0.1% -2%. The onset of bipolar disorder in children and adolescents is oftenaccompanied by a more severe disease course, compared to bipolar disorder with onset inadulthood. This case report presents a case of bipolar 1 in children accompanied bycomprehensive management.

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Pharmacological treatment of depression and bipolar disorder in children and adolescents

Advances in Psychiatric Treatment ◽

10.1192/apt.bp.108.005553 ◽

2010 ◽

Vol 16 (6) ◽

pp. 402-412 ◽

Cited By ~ 1

Author(s):

Bernadka Dubicka ◽

Paul Wilkinson ◽

Raphael G. Kelvin ◽

Ian M. Goodyer

Keyword(s):

Bipolar Disorder ◽

Children And Adolescents ◽

Treatment Guidelines ◽

Evidence Base ◽

Current Treatment ◽

Risks And Benefits ◽

Treatment Of Depression ◽

Increased Risk ◽

Potential Risks ◽

Considerable Morbidity

SummaryMajor depression and bipolar disorder in children and adolescents are serious conditions associated with considerable morbidity as well as increased risk of suicide. The treatment of depression in young people is currently controversial and this article reviews the evidence base and potential risks and benefits of antidepressants. Although the diagnosis of bipolar disorder is also controversial, medication is the first-line treatment of choice in cases that meet diagnostic criteria. The limited evidence base in children and adolescents is presented, along with current treatment guidelines. Despite the controversies in this field, this article concludes that medication remains an important part of the treatment approach for both disorders, although the risks and benefits of pharmacotherapy need to be carefully assessed in each patient.

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Evaluation of the Role of ABCB1gene Polymorphic Variants on Psychiatric Disorders Predisposition in Macedonian Population

PRILOZI ◽

10.2478/prilozi-2018-0008 ◽

2017 ◽

Vol 38 (3) ◽

pp. 71-88

Author(s):

Zorica Naumovska ◽

Aleksandra K. Nestorovska ◽

Zoran Sterjev ◽

Ana Filipce ◽

Aleksandra Grozdanova ◽

...

Keyword(s):

Bipolar Disorder ◽

Psychiatric Disorders ◽

Psychiatric Illness ◽

Cell Activation ◽

Bipolar Disorders ◽

Control Group ◽

Microglia Cell ◽

Increased Risk ◽

And Function

Abstract The psychiatric and other CNS disorders are characterized with unregulated neuro-inflammatory processes and chronic microglia cell activation resulting with detrimental effect. ABCB1gene polymorphismsC1236T, G2677T/Aand C3435T are associated with P-glycoprotein expression and function andare linked with predisposition to psychiatric disorders such as schizophrenia and bipolar disorders. The relationship between mood disorders and glucocorticoids has been confirmed and ABCB1 SNPs influence the glucocorticoids access to the brain. The aim of the study is evaluation of the influence of the three most common ABCB1SNPs on predisposition to psychiatric disorders in Macedonian population. In the study 107 unrelated healthy Macedonians of both sexes were enrolled as a control group and patient population of 54 patients (22 to 65 years old) diagnosed with schizophrenia or bipolar disorder. ABCB1 for three polymorphisms were analyzed by Real-Time PCR in both groups. The results have confirmed the role of the ABCB1 gene in predisposition to psychiatric disorders and increased risk of developing bipolar disorder in carriers of the heterozygotes and mutant homozygotes for polymorphic variations in 1236 and 2677 in comparison to the normal genotype carriers. Three-fold higher risk was estimated for psychiatric illness in women that are 1236 and 2677 heterozygous carrier (heterozygous and mutant homozygous) compared to healthy control (men and women) population and four-fold higher risk in comparison only to healthy women population. Mutant allele carriers for 1236 and 2677 polymorphisms that are 35 years and below in patients population have almost three-fold higher risk for development of psychiatric illness.

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Validity of DSM-IV ADHD Subtypes in a Nationally Representative Sample of Australian Children and Adolescents

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1097/00004583-200112000-00011 ◽

2001 ◽

Vol 40 (12) ◽

pp. 1410-1417 ◽

Cited By ~ 161

Author(s):

BRIAN W. GRAETZ ◽

MICHAEL G. SAWYER ◽

PHILIP L. HAZELL ◽

FIONA ARNEY ◽

PETER BAGHURST

Keyword(s):

Children And Adolescents ◽

Representative Sample ◽

Adhd Subtypes ◽

Dsm Iv ◽

Nationally Representative

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Increased risk of hospital admission for mood disorders following admission for epilepsy

Neurology ◽

10.1212/01.wnl.0000542492.00605.9d ◽

2018 ◽

Vol 91 (9) ◽

pp. e800-e810 ◽

Cited By ~ 6

Author(s):

Anna M. Kim ◽

Kyle C. Rossi ◽

Nathalie Jetté ◽

Ji Yeoun Yoo ◽

Kenneth Hung ◽

...

Keyword(s):

Bipolar Disorder ◽

Hospital Admission ◽

Mood Disorders ◽

Cox Regression ◽

Bipolar Disorders ◽

Medical Group ◽

Index Hospitalization ◽

Increased Risk ◽

Stroke Group ◽

Nationally Representative

ObjectiveTo determine if epilepsy admissions, compared to admissions for other medical causes, are associated with a higher readmission risk for mood disorders.MethodsThe Nationwide Readmissions Database is a nationally representative dataset comprising 49% of US hospitalizations in 2013. In this retrospective cohort study, we used ICD-9-CM codes to identify medical conditions. Index admissions for epilepsy (n = 58,278) were compared against index admissions for stroke (n = 215,821) and common medical causes (n = 973,078). Readmission rates (per 100,000 index admissions) for depression or bipolar disorders within 90 days from discharge for index hospitalization were calculated. Cox regression was used to test for associations between admission type (defined in 3 categories as above) and readmission for depression or bipolar disorder up to 1 year after index admission, in univariate models and adjusted for age, sex, psychiatric history, drug abuse, income quartile of patient's zip code, and index hospitalization characteristics.ResultsThe adjusted hazard ratio (HR) for readmission for depression in the epilepsy group was elevated at 2.80 compared to the stroke group (95% confidence interval [CI] 2.39–3.27, p < 2 × 10−16), and 2.09 compared to the medical group (95% CI 1.88–2.32, p < 2 × 10−16). The adjusted HR for readmission for bipolar disorder in the epilepsy group was elevated at 5.84 compared to the stroke group (95% CI 4.56–7.48, p < 2 × 10−16), and 2.46 compared to the medical group (95% CI 2.16–2.81, p < 2 × 10−16).ConclusionAdmission for epilepsy was independently associated with subsequent hospital readmission for mood disorders. The magnitude of elevated risk in this population suggests that patients admitted with epilepsy may warrant targeted psychiatric screening during their hospital admission.

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Comorbidity of bipolar disorder and bulimia nervosa

European Psychiatry ◽

10.1017/s0924933800002364 ◽

1994 ◽

Vol 9 (6) ◽

pp. 315-317

Author(s):

H Verdoux ◽

M Mury ◽

M Bourgeois

Keyword(s):

Bipolar Disorder ◽

Eating Disorders ◽

Bulimia Nervosa ◽

Bipolar Disorders ◽

Unipolar Depression ◽

Epidemiological Studies ◽

Increased Risk ◽

Bipolar Ii

SummaryThe association of eating disorders and bipolar disorders is less documented than the well-established association of eating disorders and unipolar depression. However, epidemiological studies have demonstrated an increased risk for bipolar disorders, especially bipolar II, in bulimic patients. We report the case of a patient displaying such a morbid association.

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HLA-E circulating and genetic determinants in schizophrenia and bipolar disorder

Scientific Reports ◽

10.1038/s41598-021-99732-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Wahid Boukouaci ◽

Mohamed Lajnef ◽

Jean-Romain Richard ◽

Ching-Lien Wu ◽

Jihène Bouassida ◽

...

Keyword(s):

Bipolar Disorder ◽

Killer Cell ◽

Bipolar Disorders ◽

Immune Dysregulation ◽

Mental Illnesses ◽

Genetic Determinants ◽

Diagnostic Biomarkers ◽

Dsm Iv ◽

Depressive Episodes ◽

Circulating Levels

AbstractSchizophrenia (SZ) and bipolar disorders (BD) are severe mental illnesses that lack reliable biomarkers to guide diagnosis and management. As immune dysregulation is associated with these disorders, we utilized the immunoregulatory functions of the natural killer cell inhibitory HLA-E locus to investigate the relationships between HLA-E genetic and expression diversities with SZ and BD risk and severity. Four hundred and forty-four patients meeting DSM-IV criteria for SZ (N = 161) or BD (N = 283) were compared to 160 heathy controls (HC). Circulating levels of the soluble isoform of HLA-E molecules (sHLA-E) were measured and HLA-E*01:01 and HLA-E*01:03 variants genotyped in the whole sample. sHLA-E circulating levels were significantly higher in both SZ and in BD patients compared to HC (pc < 0.0001 and pc = 0.0007 for SZ and BD, respectively). High sHLA-E levels were also observed in stable SZ patients and in acute BD patients experiencing depressive episodes when comparisons were made between the acute and stable subgroups of each disorder. sHLA-E levels linearly increased along HLA-E genotypes (p = 0.0036). In conclusion, HLA-E variants and level may have utility as diagnostic biomarkers of SZ and BD. The possible roles of HLA diversity in SZ and BD etiology and pathophysiology are discussed.

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Adult Bipolar Disorder is Continuous with Pediatric Bipolar Disorder

The Canadian Journal of Psychiatry ◽

10.1177/070674370705200703 ◽

2007 ◽

Vol 52 (7) ◽

pp. 418-425 ◽

Cited By ~ 18

Author(s):

Kiki Chang

Keyword(s):

Bipolar Disorder ◽

Children And Adolescents ◽

Retrospective Studies ◽

Developmental Differences ◽

Biological Assessment ◽

Pediatric Bipolar Disorder ◽

Prospective Data ◽

Developmental Models ◽

Considerable Debate ◽

Dsm Iv

Considerable debate exists regarding the continuity of bipolar disorder (BD) in children and adolescents. Do affected children continue to have BD as adults? Are pediatric forms of BD distinct from adult forms of the disorder? Here, I argue that, in fact, strictly defined BD I and II in children and adolescents is continuous with adult BD. First, if we take developmental differences into account, children and adults share similar symptoms, since they are both diagnosed according to DSM-IV criteria. Next, retrospective studies indicate that 50% to 66% of adults with BD had onset of their disorder before age 19 years. Early prospective data indicate that adolescents with BD progress to become young adults with BD. Further, family studies of pediatric BD probands find high rates of BD in adult relatives, and pediatric offspring of parents with BD have elevated rates of BD, compared with control subjects. Finally, biological characteristics of pediatric BD (such as treatment response, neurobiology, and genetics) are either shared with adults having BD or fit logically into developmental models of BD. Thus, while not conclusive, a preponderance of data support the hypothesis that pediatric BD is continuous with adult BD. Prospective studies incorporating phenomenological and biological assessment are needed to decisively address this issue.

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