Comorbidity in pediatric bipolar disorder

Abstract

The growing literature shows the pervasiveness and importance of comorbidity in youth with bipolar disorder (BPD). For instance, up to 90% of youth with BPD have been described to manifest comorbidity with attention-deficit hyperactivity disorder. Multiple anxiety, substance use, and disruptive behavior disorders are the other most commonly reported comorbidities with BPD. Moreover, important recent data highlight the importance of obsessive-compulsive and pervasive developmental illness in the context of BPD. Data suggest that not only special developmental relationships are operant in the context of comorbidity but also that the presence of comorbid disorders with BPD results in a more severe clinical condition. Moreover, the presence of comorbidity has therapeutic implications for the treatment response for both BPD and the associated comorbid disorder. Future longitudinal studies to address the relationship and the impact of comorbid disorders on course and therapeutic response over time are required in youth with BPD.

Figure-1

Rates of Psychiatric Comorbidity in Bipolar Youth Stratified by Age at Onset of BPD

Figure-2

Risk of SUD in Psychiatrically Referred Adolescent Outpatient Population

Figure-3

Development of Substance Use Disorders in Child & Adolescent-Onset BPD Adolescent Onset Bipolar (>12 years) N=38

Figure-4

Anxiety Disorders in Clinically Referred Youth with Bipolar Disorder

Figure-5

Endpoint YMRS Score Mean Change BPD+OCD Vs. BPD+GAD