Pediatric bipolar spectrum disorder and ADHD: comparison and comorbidity in the LAMS clinical sample

被引:48
作者
Arnold, L. Eugene [1 ]
Demeter, Christine [2 ]
Mount, Katherine [1 ]
Frazier, Thomas W. [3 ,4 ]
Youngstrom, Eric A. [5 ]
Fristad, Mary [1 ]
Birmaher, Boris [6 ]
Findling, Robert L. [2 ]
Horwitz, Sarah M. [7 ]
Kowatch, Robert [8 ]
Axelson, David A. [6 ]
机构
[1] Ohio State Univ, Dept Psychiat, Div Child & Adolescent Psychiat, Columbus, OH 43210 USA
[2] Case Western Reserve Univ, Dept Psychiat, Div Child & Adolescent Psychiat, Cleveland, OH 44106 USA
[3] Cleveland Clin, Ctr Pediat Behav Hlth, Cleveland, OH 44106 USA
[4] Cleveland Clin, Ctr Autism, Cleveland, OH 44106 USA
[5] Univ N Carolina, Dept Psychol, Chapel Hill, NC USA
[6] Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat, Med Ctr, Pittsburgh, PA 15213 USA
[7] Stanford Univ, Sch Med, Dept Pediat & Stanford Hlth Policy, Stanford, CA 94305 USA
[8] Nationwide Childrens Hosp, Columbus, OH USA
关键词
ADHD; bipolar; comorbidity; impairment; severity; PROSPECTIVE FOLLOW-UP; DEFICIT HYPERACTIVITY DISORDER; MANIC SYMPTOMS; LONGITUDINAL ASSESSMENT; DIAGNOSTIC-ACCURACY; RATING-SCALE; CHILDREN; ADOLESCENTS; RELIABILITY; VALIDITY;
D O I
10.1111/j.1399-5618.2011.00948.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
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.
引用
收藏
页码:509 / 521
页数:13
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