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World Journal of Pediatrics

, Volume 14, Issue 6, pp 525–527 | Cite as

ADHD-juvenile bipolar disorder: mimics and chameleons!

  • Ahmed Naguy
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Both attention-deficit/hyperactivity disorder (ADHD) and juvenile bipolar mood disorder (BP) share many clinical symptoms in common. Differentiating between both conditions is crucial, both for course and prognosis and to inform functional and therapeutic outcomes which differ considerably. Early identification and hence appropriate management may lead to improved functioning, prevention of impending emergence of comorbidities (e.g. “behavioural bouquet” of ADHD), and attenuation of the untreated course of BP [1]. If the emotional symptoms of BP are misattributed to demoralization associated with ADHD label, increased use of stimulants would expose patients to higher than needed dosing and can readily destabilize mood. On the other hand, if comorbidity with ADHD is not recognized in BP, inattention, distractibility, and talkativeness symptoms from ADHD could be inappropriately ascribed to residual symptoms of BP with subsequent unnecessary exposure to antipsychotics with...

Notes

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There is no funding data for this article.

Compliance with ethical standards

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

Author declares no conflict of interests in the past 36 months.

References

  1. 1.
    Campbell M, Cueva JE. Psychopharmacology in child and adolescent psychiatry: a review of the past seven years: part II. J Am Acad Child Adolesc Psychiatry. 1995;34:1262–72.CrossRefGoogle Scholar
  2. 2.
    State RC, Frye MA, Althsuler LL, Strober M, DeAntonio M, Hwang S, et al. Chart review of the impact of attention-deficit/hyperactivity disorder comorbidity on response to lithium or divalproex sodium in adolescent mania. J Clin Psychiatry. 2004;65:1057–63.CrossRefGoogle Scholar
  3. 3.
    Kim EY, Milkowitz DJ. Childhood mania, attention deficit hyperactivity disorder and conduct disorder: a critical review of diagnostic dilemmas. Bipolar Disord. 2002;4:215–25.CrossRefGoogle Scholar
  4. 4.
    Biederman J, Faraone SV, Spencer T, Wilens T, Mick E, Lapey KA. Gender differences in a sample of adults with attention deficit hyperactivity disorder. Psychiatry Res. 1994;53:13–29.CrossRefGoogle Scholar
  5. 5.
    Singh MK, DelBello MP, Kowatch RA, Strakowski SM. Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children. Bipolar Disord. 2006;8:710–20.CrossRefGoogle Scholar
  6. 6.
    Kowatch RA, Youngstrom EA, Danielyan A, Findling RL. Review and meta-analysis of the phenomenology and clinical characteristics of mania in children and adolescents. Bipolar Disord. 2005;7:483–96.CrossRefGoogle Scholar
  7. 7.
    DelBello MP, Adler CM, Amicone J, Mills NP, Shear PK, Warner J, et al. Parametric neurocognitive task design: a pilot study of sustained attention in adolescents with bipolar disorders. J Affect Disord. 2004;82(Suppl. 1):S79–88.CrossRefGoogle Scholar
  8. 8.
    Perlis RH, Miyahara S, Marangell LB, Wisniewski SR, Ostacher M, DelBello MP, et al. Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD). Biol Psychiatry. 2004;55:875–81.CrossRefGoogle Scholar
  9. 9.
    Henin A, Biederman J, Mick E, Sachs GS, Hirshfeld-Becker DR, Siegel RS, et al. Psychopathology in the offspring of parents with bipolar disorder: a controlled study. Biol Psychiatry. 2005;58:554–61.CrossRefGoogle Scholar
  10. 10.
    Carlson GA, Loney J, Salisbury H, Kramer JR, Arthur C. Stimulant treatment in young boys with symptoms suggesting childhood mania: a report from a longitudinal study. J Child Adolesc Psychopharmacol. 2000;10:175–84.CrossRefGoogle Scholar
  11. 11.
    Geller B, Zimerman MA, Williams M, DelBello MP, Bolhofner K, Craney JL, et al. DSM-IV mania symptoms in a prepubertal and early adolescent bipolar disorder phenotype compared to attention-deficit hyperactive and normal controls. J Child Adolesc Psychopharmacol. 2002;12:11–25.CrossRefGoogle Scholar
  12. 12.
    Mick E, Biederman J, Pandina G, Faraone SV. A preliminary meta-analysis of the child behavior checklist in pediatric bipolar disorder. Biol Psychiatry. 2003;53:1021–7.CrossRefGoogle Scholar
  13. 13.
    Faraone SV, Althoff RR, Hudziak JJ, et al. The CBCL predicts DSM bipolar disorder in children: a receiver operating characteristic curve analysis. Bipolar Disord. 2005;7:518–24.CrossRefGoogle Scholar
  14. 14.
    Biederman J, Petty CR, Monuteaux MC, Evans M, Parcell T, Faraone SV, et al. The child behaviour checklist-pediatric bipolar disorder profile predicts a subsequent diagnosis of bipolar disorder and associated impairments in ADHD youth growing up: a longitudinal analysis. J Clin Psychiatry. 2009;70:732–40.CrossRefGoogle Scholar
  15. 15.
    Faraone SV, Biederman J, Mennin D, Russell R. Bipolar and antisocial disorders among relatives of ADHD children: parsing familial subtypes of illness. Am J Med Genet. 1998;81:108–16.CrossRefGoogle Scholar
  16. 16.
    Wilens T, Biederman J, Wozniack J, Gunawardene S, Wong J, Monuteaux M. Can adults with attention-deficit hyperactivity disorder be distinguished from those with comorbid bipolar disorder: findings from a sample of clinically referred adults. Biol Psychiatry. 2003;54:1–8.CrossRefGoogle Scholar
  17. 17.
    Naguy A. Psychopharmacotherapy of attention-deficit/hyperactivity disorder complex presentations. Pediatr Neurol. In Press 2017.Google Scholar
  18. 18.
    Wilens TE, Prince JB, Spencer T, Van Patten SL, Doyle R, Girard K, Hammarness P, et al. An open trial of bupropion for the treatment of adults with attention deficit hyperactivity disorder and bipolar disorder. Biol Psychiatry. 2003;54:9–16.CrossRefGoogle Scholar
  19. 19.
    Hah M, Chang K. Atomoxetine for the treatment of attention-deficit/hyperactivity disorder in children and adolescents with bipolar disorders. J Child Adolesc Psychopharmacol. 2005;15:996–1004.CrossRefGoogle Scholar
  20. 20.
    Jaworowski S, Benarroch F, Gross-Tsur V. Concomitant use of atomoxetine and OROS-methylphenidate in a 10-year-old child suffering from attention-deficit/hyperactivity disorder with comorbid bipolar disorder and Tourette syndrome. J Child Adolesc Psychopharmacol. 2006;16:365–70.CrossRefGoogle Scholar

Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2018

Authors and Affiliations

  1. 1.Al-Manara CAP Centre, KCMHShuwaikhKuwait

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