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Comorbidity in pediatric bipolar disorder: prevalence, clinical impact, etiology and treatment

Álvaro Frías1, Cárol Palma1, Núria Farriols1

  • 1FPCEE Blanquerna, University of Ramon-Llull, Císterst 34, 08022 Barcelona, Spain; Adult Outpatient Mental Health Center, Hospital of Mataró, Mataró, Spain.

Journal of Affective Disorders
|December 30, 2014
PubMed

Insights

Pediatric bipolar disorder (PBD) frequently co-occurs with other conditions like anxiety and ADHD, negatively impacting youth. Effective treatments are emerging for these comorbidities.

Area of Science:

  • Child and Adolescent Psychiatry
  • Neurodevelopmental Disorders
  • Mental Health Research

Background:

  • Pediatric bipolar disorder (PBD) research increasingly highlights significant comorbidity.
  • Understanding these co-occurring conditions is crucial for effective PBD management.

Purpose of the Study:

  • To systematically review the prevalence, clinical impact, etiology, and treatment of disorders comorbid with PBD.
  • To synthesize current evidence on the interplay between PBD and other psychiatric conditions in youth.

Main Methods:

  • A comprehensive literature search was conducted from 1990 to August 2014.
  • 167 studies met the inclusion criteria for the systematic review.

Main Results:

  • Anxiety disorders (54%), ADHD (48%), disruptive behavior disorders (31%), and substance use disorders (31%) are highly prevalent comorbidities in PBD.
  • Comorbid ADHD and anxiety disorders worsen PBD symptoms, neurocognition, and overall functioning.
  • Stimulants and atomoxetine show efficacy as adjunctive treatments for ADHD in PBD; mood stabilizers and SGAs may benefit other comorbidities.

Conclusions:

  • High comorbidity in PBD has detrimental clinical effects, with diverse etiological pathways.
  • Further research is needed on the etiology and treatment of PBD comorbidities, particularly pervasive developmental and anxiety disorders.
  • Epidemiologic studies are essential to refine understanding and avoid nosological artifacts.
Abstract

Keywords:
Anxiety disorderAttention deficit hyperactivity disorderDisruptive behavior disorderPediatric bipolar disorderPervasive developmental disorderSubstance use disorder

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