Bipolar Disorder and ADHD: Comorbidity and Diagnostic Distinctions

Abstract

Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) are neurodevelopmental disorders with onset in childhood and early adolescence, and common persistence in adulthood. Both disorders are often undiagnosed, misdiagnosed, and sometimes over diagnosed, leading to high rates of morbidity and disability. The differentiation of these conditions is based on their clinical features, comorbidity, psychiatric family history course of illness, and response to treatment. We review recent relevant findings and highlight epidemiological, clinical, family history, course, and treatment-response differences that can aid the differential diagnosis of these conditions in an outpatient pediatric setting.

This is a preview of subscription content, log in to check access.

References

  1. 1.••

    Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010;49:980–9. Epidemiology of adolescents mental health in the US, with prevalence and mean age of onset for the most common youth mental health issues.

    PubMed Central  PubMed  Article  Google Scholar 

  2. 2.

    Evans-Lacko SE, Zeber JE, Gonzalez JM, Olvera RL. Medical comorbidity among youth diagnosed with bipolar disorder in the United States. J Clin Psychiatry. 2009;70(10):1461–6.

    PubMed  Article  Google Scholar 

  3. 3.

    Hodgkins P, Montejano L, Sasané R, Huse D. Cost of illness and comorbidities in adults diagnosed with attention-deficit/hyperactivity disorder: a retrospective analysis. Prim Care Companion CNS Disord. 2011;13(2):e1–e12.

  4. 4.

    Cherkasova M, Sulla EM, Dalena KL, Pondé MP, Hechtman L. Developmental course of attention deficit hyperactivity disorder and its predictors. J Can Acad Child Adolesc Psychiatry. 2013;22(1):47–54.

    PubMed Central  PubMed  Article  Google Scholar 

  5. 5.

    Frías Á, Palma C, Farriols N. Comorbidity in pediatric bipolar disorder: prevalence, clinical impact, etiology and treatment. J Affect Disord. 2015;174C:378–89.

    Article  Google Scholar 

  6. 6.

    Singh I. Beyond polemics: science and ethics of ADHD. Nat Rev Neurosci. 2008;9(12):957–64.

    CAS  PubMed  Article  Google Scholar 

  7. 7.

    Feldman HM, Reiff MI. Clinical practice. Attention deficit-hyperactivity disorder in children and adolescents. N Engl J Med. 2014;370(9):838–46.

    CAS  PubMed  Article  Google Scholar 

  8. 8.

    Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol. 2014;43(2):434–42.

    PubMed  Article  Google Scholar 

  9. 9.

    Lee SI. Predictive validity of DSM-IV and ICD-10 criteria for ADHD and hyperkinetic disorder. J Child Psychol Psychiatry. 2008;49(1):70–8.

    PubMed  Article  Google Scholar 

  10. 10.•

    Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345–65. A meta-analysis of rates of mental illness in different countries, including differences in criteria used, training of clinicians, instruments used for the diagnoses.

    PubMed  Article  Google Scholar 

  11. 11.

    Garfield LD, Brown DS, Allaire BT, Ross RE, Nicol GE, et al. Psychotropic drug use among preschool children in the Medicaid program from 36 states. Am J Public Health. 2015;105(3):524–9.

    PubMed  Article  Google Scholar 

  12. 12.

    Moreno C, Laje G, Blanco C, Jiang H, Schmidt AB, Olfson M. National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Arch Gen Psychiatry. 2007;64(9):1032–9.

    PubMed  Article  Google Scholar 

  13. 13.

    Jensen P, Hinshaw SP, Swanson JM, Greenhill LL, Conners CK, Arnold LE, et al. Findings from the NIMH Multi-modal Treatment Study (MTA): implications and applications for primary care providers. J Dev Behav Pediatr. 2001;22(1):60–73.

    CAS  PubMed  Article  Google Scholar 

  14. 14.

    Biederman J, Mick E, Faraone SV, Spencer J, Wilens TE, Wozniak J. Pediatric mania: a developmental subtype of bipolar disorder? Biol Psychiatry. 2000;48(6):458–66.

    CAS  PubMed  Article  Google Scholar 

  15. 15.

    Goldman LS, Genel M, Bezman RJ, Slanetz PJ. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Council on Scientific Affairs, American Medical Association. JAMA. 1998;279(14):1100–7.

    CAS  PubMed  Article  Google Scholar 

  16. 16.

    Center for Disease Control and Prevention (CDC). Attention-deficit/hyperactivity disorder (ADHD). 2005. Available from: http://www.cdc.gov/ncbddd/adhd/.

  17. 17.

    Baroni A, Castellanos FX. Neuroanatomic and cognitive abnormalities in attention-deficit/hyperactivity disorder in the era of ‘high definition’ neuroimaging. Curr Opin Neurobiol. 2015;30:1–8.

    CAS  PubMed  Article  Google Scholar 

  18. 18.

    Van Meter AR, Moreira AL, Youngstrom EA. Meta-analysis of epidemiologic studies of pediatric bipolar disorder. J Clin Psychiatry. 2011;72(9):1250–6.

    PubMed  Article  Google Scholar 

  19. 19.

    Leverich GS, Post RM, Keck Jr PE, Altshuler LL, Frye MA, Kupka RW, et al. The poor prognosis of childhood-onset bipolar disorder. J Pediatr. 2007;150(5):485–90.

    PubMed  Article  Google Scholar 

  20. 20.

    Perlis RH, Dennehy EB, Miklowitz DJ, Delbello MP, Ostacher M, Calabrese JR, et al. Retrospective age at onset of bipolar disorder and outcome during two-year follow-up: results from the STEP-BD study. Bipolar Disord. 2009;11(4):391–400.

    PubMed Central  PubMed  Article  Google Scholar 

  21. 21.••

    Birmaher B, Axelson D, Goldstein B, Strober M, Gill MK, Hunt J, et al. Four-year longitudinal course of children and adolescents with bipolar spectrum disorders: the Course and Outcome of Bipolar Youth (COBY) study. Am J Psychiatry. 2009;166(7):795–804. Clinical features of bipolar disorder in youths during prospective follow-up of four-years. Some cases of BP-NOS progress to BP-I or –II, while others remain BP-NOS, or fail to persist.

    PubMed Central  PubMed  Article  Google Scholar 

  22. 22.

    Axelson DA, Birmaher B, Strober MA, Goldstein BI, Ha W, Gill MK, et al. Course of subthreshold bipolar disorder in youth: diagnostic progression from bipolar disorder not otherwise specified. J Am Acad Child Adolesc Psychiatry. 2011;50(10):1001–16.

    PubMed Central  PubMed  Article  Google Scholar 

  23. 23.

    Safer DJ, Rajakannan T, Burcu M, Zito JM. Trends in subthreshold psychiatric diagnoses for youth in community treatment. JAMA Psychiatry. 2015;72(1):75–83.

    PubMed  Article  Google Scholar 

  24. 24.

    Nierenberg AA, Miyahara S, Spencer T, Wisniewski SR, Otto MW, Simon N, et al. Clinical and diagnostic implications of lifetime attention-deficit/hyperactivity disorder comorbidity in adults with bipolar disorder: data from the first 1000 STEP-BD participants. Biol Psychiatry. 2005;57(11):1467–73.

    PubMed  Article  Google Scholar 

  25. 25.

    Beesdo K, Höfler M, Leibenluft E, Lieb R, Bauer M, Pfennig A. Mood episodes and mood disorders: patterns of incidence and conversion in the first three decades of life. Bipolar Disord. 2009;11(6):637–49.

    PubMed Central  PubMed  Article  Google Scholar 

  26. 26.

    Klein RG, Mannuzza S, Olazagasti MA, Roizen E, Hutchison JA, Lashua EC, et al. Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later. Arch Gen Psychiatry. 2012;69(12):1295–303.

    PubMed Central  PubMed  Article  Google Scholar 

  27. 27.

    Chen MH, Su TP, Chen YS, Hsu JW, Huang KL, Chang WH, et al. Higher risk of developing mood disorders among adolescents with comorbidity of attention deficit hyperactivity disorder and disruptive behavior disorder: a nationwide prospective study. J Psychiatr Res. 2013;47(8):1019–23.

    PubMed  Article  Google Scholar 

  28. 28.•

    Jerrell JM, McIntyre RS, Park YM. Correlates of incident bipolar disorder in children and adolescents diagnosed with attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2014;75(11):e1278–83. A rare prospective study of predictors of bipolar disorder among youths treated for ADHD, including clinical features and treatment response.

    PubMed  Article  Google Scholar 

  29. 29.

    Koolwijk I, Stein DS, Chan E, Powell C, Driscoll K, Barbaresi WJ. “Complex” attention-deficit hyperactivity disorder, more norm than exception? Diagnoses and comorbidities in a developmental clinic. J Dev Behav Pediatr. 2014;35(9):591–7.

    PubMed  Article  Google Scholar 

  30. 30.

    Sihvola E, Rose RJ, Dick DM, Korhonen T, Pulkkinen L, Raevuori A, et al. Prospective relationships of ADHD symptoms with developing substance use in a population-derived sample. Psychol Med. 2011;41(12):2615–23.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  31. 31.

    Dalsgaard S, Mortensen PB, Frydenberg M, Thomsen PH. ADHD, stimulant treatment in childhood and subsequent substance abuse in adulthood—a naturalistic long-term follow-up study. Addict Behav. 2014;39(1):325–8.

    PubMed  Article  Google Scholar 

  32. 32.

    Mannuzza S, Klein RG, Truong NL, Moulton 3rd JL, Roizen ER, Howell KH, et al. Age of methylphenidate treatment initiation in children with ADHD and later substance abuse: prospective follow-up into adulthood. Am J Psychiatry. 2008;165(5):604–9.

    PubMed Central  PubMed  Article  Google Scholar 

  33. 33.

    Biederman J, Faraone S, Mick E, Wozniak J, Chen L, Ouellette C, et al. Attention-deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity? J Am Acad Child Adolesc Psychiatry. 1996;35(8):997–1008.

    CAS  PubMed  Article  Google Scholar 

  34. 34.

    Biederman J, Faraone S, Milberger S, Guite J, Mick E, Chen L, et al. A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch Gen Psychiatry. 1996;53(5):437–46.

    CAS  PubMed  Article  Google Scholar 

  35. 35.

    Duffy A. The nature of the association between childhood ADHD and the development of bipolar disorder: a review of prospective high-risk studies. Am J Psychiatry. 2012;169(12):1247–55.

    PubMed  Article  Google Scholar 

  36. 36.

    Geller B, Williams M, Zimerman B, Frazier J, Beringer L, Warner KL. Prepubertal and early adolescent bipolarity differentiate from ADHD by manic symptoms, grandiose delusions, ultra-rapid or ultradian cycling. J Affect Disord. 1998;51(2):81–91.

    CAS  PubMed  Article  Google Scholar 

  37. 37.

    Fergus EL, Miller RB, Luckenbaugh DA, Leverich GS, Findling RL, Speer AM, et al. Is there progression from irritability/dyscontrol to major depressive and manic symptoms? A retrospective community survey of parents of bipolar children. J Affect Disord. 2003;77(1):71–8.

    PubMed  Article  Google Scholar 

  38. 38.

    Luckenbaugh DA, Findling RL, Leverich GS, Pizzarello SM, Post RM. Earliest symptoms discriminating juvenile-onset bipolar illness from ADHD. Bipolar Disord. 2009;11(4):441–51.

    PubMed  Article  Google Scholar 

  39. 39.

    Faraone SV, Althoff RR, Hudziak JJ, Monuteaux M, Biederman J. The CBCL predicts DSM bipolar disorder in children: a receiver operating characteristic curve analysis. Bipolar Disord. 2005;7(6):518–24.

    PubMed  Article  Google Scholar 

  40. 40.

    Uchida M, Faraone SV, Martelon M, Kenworthy T, Woodworth KY, Spencer TJ, et al. Further evidence that severe scores in the aggression/anxiety-depression/attention subscales of child behavior checklist (severe dysregulation profile) can screen for bipolar disorder symptomatology: a conditional probability analysis. J Affect Disord. 2014;165:81–6.

    PubMed Central  PubMed  Article  Google Scholar 

  41. 41.

    Diler RS, Birmaher B, Axelson D, Goldstein B, Gill M, Strober M, et al. The Child Behavior Checklist (CBCL) and the CBCL-bipolar phenotype are not useful in diagnosing pediatric bipolar disorder. J Child Adolesc Psychopharmacol. 2009;19(1):23–30.

    PubMed Central  PubMed  Article  Google Scholar 

  42. 42.

    Doerfler LA, Connor DF, Toscano Jr PF. Aggression, ADHD symptoms, and dysphoria in children and adolescents diagnosed with bipolar disorder and ADHD. J Affect Disord. 2011;131(1–3):312–9.

    PubMed  Article  Google Scholar 

  43. 43.

    Etain B, Jamain S, Milhiet V, Lajnef M, Boudebesse C, Dumaine A, et al. Association between circadian genes, bipolar disorders and chronotypes. Chronobiol Int. 2014;31(7):807–14.

    CAS  PubMed  Article  Google Scholar 

  44. 44.

    Teicher MH, Faedda GL, Baroni A, McGreenery CE, Hernandez M, Grant MC, et al. Actigraphy rest-activity disturbances discriminate pediatric Bipolar Disorder from attention Deficit Hyperactivity Disorder and typically-developing controls. Biol Psychiatry. 2013;73(1S):312.

    Google Scholar 

  45. 45.

    Faedda GL, Baldessarini RJ, Suppes T, Tondo L, Becker I, Lipschitz DS. Pediatric-onset bipolar disorder: a neglected clinical and public health problem. Harv Rev Psychiatry. 1995;3(4):171–95.

    CAS  PubMed  Article  Google Scholar 

  46. 46.

    Teicher MH. Actigraphy and motion analysis: new tools for psychiatry. Harv Rev Psychiatry. 1995;3(1):18–35.

    CAS  PubMed  Article  Google Scholar 

  47. 47.

    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(6):483–96.

    PubMed  Article  Google Scholar 

  48. 48.

    Baroni A, Hernandez M, Grant MC, Faedda GL. Sleep disturbances in pediatric bipolar disorder: a comparison between bipolar I and bipolar NOS. Front Psychiatry. 2012;3:22.

    PubMed Central  PubMed  Article  Google Scholar 

  49. 49.

    Cortese S, Faraone SV, Konofal E, Lecendreux M. Sleep in children with attention-deficit/hyperactivity disorder: meta-analysis of subjective and objective studies. J Am Acad Child Adolesc Psychiatry. 2009;48(9):894–908.

    PubMed  Google Scholar 

  50. 50.

    Masi G, Mucci M, Pfanner C, Berloffa S, Magazù A, Perugi G. Developmental pathways for different subtypes of early-onset bipolarity in youths. J Clin Psychiatry. 2012;73(10):1335–41.

    PubMed  Article  Google Scholar 

  51. 51.

    Faedda GL, Marangoni C, Serra G, Salvatore P, Sani G, Vasquez GH et al. Precursors of bipolar disorder: a systematic literature review of prospective studies. J Clin Psychiatry. 2015;76(5):614–24.

  52. 52.

    Goldstein TR, Ha W, Axelson DA, Goldstein BI, Liao F, Gill MK, et al. Predictors of prospectively examined suicide attempts among youth with bipolar disorder. Arch Gen Psychiatry. 2012;69(11):1113–22.

    PubMed Central  PubMed  Article  Google Scholar 

  53. 53.

    Ljung T, Chen Q, Lichtenstein P, Larsson H. Common etiological factors of attention-deficit/hyperactivity disorder and suicidal behavior: a population-based study in Sweden. JAMA Psychiatry. 2014;71(8):958–64.

    PubMed  Article  Google Scholar 

  54. 54.

    Ballester J, Goldstein T, Goldstein B, Obreja M, Axelson D, Monk K, et al. Is bipolar disorder specifically associated with aggression? Bipolar Disord. 2012;14(3):283–90.

    PubMed Central  PubMed  Article  Google Scholar 

  55. 55.

    Geller B, Zimerman B, Williams M, Delbello MP, Frazier J, Beringer L. Phenomenology of prepubertal and early adolescent bipolar disorder: examples of elated mood, grandiose behaviors, decreased need for sleep, racing thoughts and hypersexuality. J Child Adolesc Psychopharmacol. 2002;12(1):3–9.

    PubMed  Article  Google Scholar 

  56. 56.

    Bohman H, Jonsson U, Päären A, von Knorring L, Olsson G, von Knorring AL. Prognostic significance of functional somatic symptoms in adolescence: a 15-year community-based follow-up study of adolescents with depression compared with healthy peers. BMC Psychiatry. 2012;12:90.

    PubMed Central  PubMed  Article  Google Scholar 

  57. 57.

    Wozniak J, Faraone SV, Martelon M, McKillop HN, Biederman J. Further evidence for robust familiality of pediatric bipolar I disorder: results from a very large controlled family study of pediatric bipolar I disorder and a meta-analysis. J Clin Psychiatry. 2012;73(10):1328–34.

    PubMed Central  PubMed  Article  Google Scholar 

  58. 58.

    Smoller JW, Finn CT. Family, twin, and adoption studies of bipolar disorder. Am J Med Genet C: Semin Med Genet. 2003;123C(1):48–58.

    Article  Google Scholar 

  59. 59.

    Song J, Bergen SE, Kuja-Halkola R, Larsson H, Landén M, Lichtenstein P. Bipolar disorder and its relation to major psychiatric disorders: a family-based study in the Swedish population. Bipolar Disord. 2015;17(2):184–93.

    PubMed  Article  Google Scholar 

  60. 60.

    Bienvenu OJ, Davydow DS, Kendler KS. Psychiatric ‘diseases’ versus behavioral disorders and degree of genetic influence. Psychol Med. 2011;41(1):33–40.

    CAS  PubMed  Article  Google Scholar 

  61. 61.

    Berman SM, Kuczenski R, McCracken JT, London ED. Potential adverse effects of amphetamine treatment on brain and behavior: a review. Mol Psychiatry. 2009;14(2):123–42.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  62. 62.•

    Faraone SV, Biederman J, Wozniak J. Examining the comorbidity between attention deficit hyperactivity disorder and bipolar I disorder: a meta-analysis of family genetic studies. Am J Psychiatry. 2012;169(12):1256–66. A meta-analysis of familial transmission of comorbid ADHD and bipolar disorder, showing elevated risk for both conditions.

    PubMed  Article  Google Scholar 

  63. 63.

    Coon ER, Quinonez RA, Moyer VA, Schroeder AR. Overdiagnosis: how our compulsion for diagnosis may be harming children. Pediatrics. 2014;134(5):1013–23.

    PubMed  Article  Google Scholar 

  64. 64.

    Arnold LE, Ganocy SJ, Mount K, Youngstrom EA, Frazier T, Fristad M, et al. Three-year latent class trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms in a clinical sample not selected for ADHD. J Am Acad Child Adolesc Psychiatry. 2014;53(7):745–60.

    PubMed Central  PubMed  Article  Google Scholar 

  65. 65.

    Judd LL, Schettler PJ, Akiskal H, Coryell W, Fawcett J, Fiedorowicz JG, et al. Prevalence and clinical significance of subsyndromal manic symptoms, including irritability and psychomotor agitation, during bipolar major depressive episodes. J Affect Disord. 2012;138(3):440–8.

    PubMed Central  PubMed  Article  Google Scholar 

  66. 66.

    Kessler RC, Green JG, Adler LA, Barkley RA, Chatterji S, Faraone SV, et al. Structure and diagnosis of adult attention-deficit/hyperactivity disorder: analysis of expanded symptom criteria from the Adult ADHD Clinical Diagnostic Scale. Arch Gen Psychiatry. 2010;67(11):1168–78.

    PubMed Central  PubMed  Article  Google Scholar 

  67. 67.

    Lahey BB, Pelham WE, Loney J, Kipp H, Ehrhardt A, Lee SS, et al. Three-year predictive validity of DSM-IV attention deficit hyperactivity disorder in children diagnosed at 4–6 years of age. Am J Psychiatry. 2004;161(11):2014–20.

    PubMed  Article  Google Scholar 

  68. 68.

    Ricaurte GA, Mechan AO, Yuan J, Hatzidimitriou G, Xie T, Mayne AH, et al. Amphetamine treatment similar to that used in the treatment of adult attention-deficit/ hyperactivity disorder damages dopaminergic nerve endings in the striatum of adult nonhuman primates. J Pharmacol Exp Ther. 2005;315(1):91.

    CAS  PubMed  Article  Google Scholar 

  69. 69.•

    Lakhan SE, Kirchgessner A. Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: misuse, cognitive impact, and adverse effects. Brain Behav. 2012;2(5):661–77. A review of medication’ safety of stimulants in ADHD, potential for abuse, overdosing, contraband, withdrawal and effect on cognitive functions.

    PubMed Central  PubMed  Article  Google Scholar 

  70. 70.

    Weyandt LL, Oster DR, Marraccini ME, Gudmundsdottir BG, Munro BA, Zavras BM, et al. Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants. Psychol Res Behav Manag. 2014;7:223–49.

    PubMed Central  PubMed  Article  Google Scholar 

  71. 71.

    Dols A, Sienaert P, van Gerven H, Schouws S, Stevens A, Kupka R, et al. The prevalence and management of side effects of lithium and anticonvulsants as mood stabilizers in bipolar disorder from a clinical perspective: a review. Int Clin Psychopharmacol. 2013;28(6):287–96.

    PubMed  Article  Google Scholar 

  72. 72.

    Young SL, Taylor M, Lawrie SM. “First do no harm”. A systematic review of the prevalence and management of antipsychotic adverse effects. J Psychopharmacol. 2015;29(4):353–62.

    CAS  PubMed  Article  Google Scholar 

  73. 73.

    Goldsmith M, Singh M, Chang K. Antidepressants and psychostimulants in pediatric populations: is there an association with mania? Paediatr Drugs. 2011;13(4):225–43.

    PubMed Central  PubMed  Article  Google Scholar 

  74. 74.

    Clavenna A, Bonati M. Safety of medicines used for ADHD in children: a review of published prospective clinical trials. Arch Dis Child. 2014;99(9):866–72.

    PubMed  Article  Google Scholar 

  75. 75.

    Biederman J, Monuteaux MC, Mick E. Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study. Psychol Med. 2006;36(2):167–79.

    PubMed  Article  Google Scholar 

  76. 76.

    Tillman R, Geller B. Controlled study of switching from attention deficit⁄ hyperactivity disorder to a prepubertal and early adolescent bipolar I disorder phenotype during 6-year prospective follow-up: rate, risk, and predictors. Dev Psychopathol. 2006;18(4):1037–53.

    PubMed  Article  Google Scholar 

  77. 77.

    Pataki C, Carlson GA. The comorbidity of ADHD and bipolar disorder: any less confusion? Curr Psychiatry Rep. 2013;15(7):372.

    PubMed  Article  Google Scholar 

  78. 78.

    Gaynes BN, Christian R, Saavedra LM, Wines R, Jonas DE, Viswanathan M, et al. Attention-deficit/hyperactivity disorder: identifying high priority future research needs. J Psychiatr Pract. 2014;20(2):104–17.

    PubMed  Article  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Ciro Marangoni and Lavinia De Chiara declare that they have no conflict of interest.

Gianni L. Faedda has received royalties for book: “Parenting a Bipolar Child”, New Harbinger Publishing, CA.

Human and Animal Rights and Informed Consent

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

Author information

Affiliations

Authors

Corresponding author

Correspondence to Gianni L. Faedda.

Additional information

This article is part of the Topical Collection on Bipolar Disorders

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Marangoni, C., De Chiara, L. & Faedda, G.L. Bipolar Disorder and ADHD: Comorbidity and Diagnostic Distinctions. Curr Psychiatry Rep 17, 67 (2015). https://doi.org/10.1007/s11920-015-0604-y

Download citation

Keywords

  • Adolescent
  • Attention deficit-hyperactivity disorder
  • Bipolar disorder
  • Child
  • Clinical features
  • Course
  • Differential diagnosis
  • Treatment