Clinical interplay between autism spectrum disorder and bipolar disorder: a narrative review

Autism spectrum disorder (ASD) and bipolar disorder (BD) pose significant diagnostic challenges due to their clinical complexity. This review aims to examine the interface and overlapping features of these conditions, with a particular focus on the challenges associated with their comorbidity.

We conducted a narrative review to examine clinical overlap, common psychiatric comorbidities, and a shared neurobiological basis between ASD and BD.

There is a notable convergence of symptoms in ASD and BD, including mood instability and emotional dysregulation; irritability, impulsivity, and aggressive behavior; deficits in social skills and social cognition; impairments in executive functions; sleep disturbances; problematic sexual behaviors; and sensory sensitivities. Common psychiatric comorbidities and shared neurobiological basis further underscore this potential interplay.

Despite distinct clinical trajectories and diagnostic criteria, our findings indicate a significant overlap in symptoms and clinical presentations between ASD and BD. This complexity makes it challenging to identify the co-occurrence of ASD and BD, which can lead to difficulties in accurately diagnosing and managing both conditions simultaneously.