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Adult attention-deficit hyperactivity disorder and bipolar disorder

  • Andrew Gleason and David Castle
Summary

Increasing attention is being paid to the concept of attention-deficit hyperactivity disorder (ADHD) in adults, in concord with evidence that suggests a proportion of children with ADHD continue to manifest symptoms into adulthood. Attention-deficit hyperactivity disorder has some symptoms in common with hypomania, and can co-occur with bipolar disorder. The diagnosis and management of ADHD in adults with bipolar disorder can be complicated, owing to challenges resulting from symptom overlap, questions of diagnostic validity and a paucity of empirical evidence to guide treatment. This article addresses comorbid ADHD and bipolar disorder, and provides practical suggestions for diagnosis and management.

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Copyright
Corresponding author
Dr Andrew Gleason, Neuropsychiatry Unit, Royal Melbourne Hospital, VIC 3050, Australia. Email: andrew.gleason@mh.org.au
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Declaration of Interest

D.C. has received fees from major pharmaceutical companies as a board member and for consultancy, grants and lectures.

Footnotes
References
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American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). APA.
Andreasen, NC (2007) DSM and the death of phenomenology in America: an example of unintended consequences. Schizophrenia Bulletin 33: 108–12.
Asherson, P, Adamou, M, Bolea, B et al (2010) Is ADHD a valid diagnosis in adults? Yes. BMJ 340: c549.
Carlat, DJ (2007) My favorite tips for sorting out diagnostic quandaries with bipolar disorder and adult attention-deficit hyperactivity disorder. Psychiatric Clinics of North America 30: 233–8.
Clark, L, Goodwin, GM (2004) State- and trait-related deficits in sustained attention in bipolar disorder. European Archives of Psychiatry and Clinical Neuroscience 254: 61–8.
Gabbard, GO (2005) Psychodynamic Psychiatry in Clinical Practice. American Psychiatric Publishing.
Hegerl, U, Himmerich, H, Engmann, B et al (2010) Mania and attention-deficit/hyperactivity disorder: common symptomatology, common pathophysiology and common treatment? Current Opinion in Psychiatry 23: 17.
Hensch, T, Himmerich, H, Hegerl, U et al (2010) Stimulants in bipolar disorder: beyond common beliefs. CNS Spectrums 15: 469–72.
Janakiraman, R, Benning, T (2010) Attention-deficit hyperactivity disorder in adults. Advances in Psychiatric Treatment 16: 96104.
Judd, LL, Akiskal, HS, Schettler, PJ et al (2002) The long-term natural history of the weekly symptomatic status of bipolar I disorder. Archives of General Psychiatry 59: 530–7.
Judd, LL, Akiskal, HS, Schettler, PJ et al (2003) A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Archives of General Psychiatry 60: 261–9.
Klassen, LJ, Katzman, MA, Chokka, P (2010) Adult ADHD and its comorbidities, with a focus on bipolar disorder. Journal of Affective Disorders 124: 18.
Knight, LA, Rooney, M, Chronis-Tuscano, A (2008) Psychosocial treatments for attention-deficit/hyperactivity disorder. Current Psychiatry Reports 10: 412–8.
Lauder, SD, Berk, M, Castle, DJ et al (2010) The role of psychotherapy in bipolar disorder. Medical Journal of Australia 193: S315.
Lydon, E, El-Mallakh, RS (2006) Naturalistic long-term use of methylphenidate in bipolar disorder. Journal of Clincal Psychopharmacology 26: 516–8.
Milberger, S, Biederman, J, Faraone, SV et al (1995) Attention deficit hyperactivity disorder and comorbid disorders: issues of overlapping symptoms. American Journal of Psychiatry 152: 1793–9.
Moncrieff, J, Timimi, S (2010) Is ADHD a valid diagnosis in adults? No. BMJ 340: c547.
Morriss, R (2004) The early warning symptom intervention for patients with bipolar affective disorder. Advances in Psychiatric Treatment 10: 1826.
Mullen, PE (2007) A modest proposal for another phenomenological approach to psychopathology. Schizophrenia Bulletin 33: 113–21.
Murphy, KR, Adler, LA (2004) Assessing attention-deficit/hyperactivity disorder in adults: focus on rating scales. Journal of Clinical Psychiatry 65 (suppl 3): 13–7.
Newcorn, JH (2007) Age-related considerations in the treatment of ADHD. CNS Spectrums 12 (suppl 23): 10–3.
Nierenberg, AA, Miyahara, S, Spencer, T et al (2005) Clinical and diagnostic implications of lifetime attention-deficit/hyperactivity disorder comorbidity in adults with bipolar disorder: data from the first 1000 STEP-bipolar disorder participants. Biological Psychiatry 57: 1467–73.
Parker, GB (2010) Comorbidities in bipolar disorder: models and management. Medical Journal of Australia 293: S1820.
Ryden, E, Thase, ME, Straht, D et al (2009) A history of childhood attention-deficit hyperactivity disorder (ADHD) impacts clinical outcome in adult bipolar patients regardless of current ADHD. Acta Psychiatrica Scandinavica 120: 239–46.
Sachs, GS, Baldassano, CF, Truman, CJ et al (2000) Comorbidity of attention deficity hyperactivity disorder with early- and late-onset bipolar disorder. American Journal of Psychiatry 157: 466–8.
Scheffer, RE (2007) Concurrent ADHD and bipolar disorder. Current Psychiatry Reports 9: 415–9.
Sentissi, O, Navarro, JC, Oliveira, HD et al (2008) Bipolar disorders and quality of life: the impact of attention deficit/hyperactivity disorder and substance abuse in euthymic patients. Psychiatry Research 161: 3642.
Solanto, MV, Marks, DJ, Wasserstein, J et al (2010) Efficacy of metacognitive therapy for adult ADHD. American Journal of Psychiatry 167: 958–68.
Soreca, I, Frank, E, Kupfer, KJ (2009) The phenomenology of bipolar disorder: what drives the high rate of medical burden and determines long-term prognosis? Depression and Anxiety 26: 7382.
Tamam, L, Tuglu, C, Karatas, G et al (2006) Adult attention-deficit hyperactivity disorder in patients with bipolar I disorder in remission: preliminary study. Psychiatry and Clinical Neurosciences 60: 480–5.
Trollor, JN (1999) Attention deficit hyperactivity disorder in adults: conceptual and clinical issues. Medical Journal of Australia 171: 421–5.
Wilens, TE, Prince, JB, Spencer, T et al (2003) An open trial of bupropion for the treatment of adults with attention-deficit/hyperactivity disorder and bipolar disorder. Biological Psychiatry 54: 916.
Wingo, AP, Ghaemi, SN (2007) A systematic review of rates and diagnositc validity of comorbid adult attention-deficit/hyperactivity disorder and bipolar disorder. Jounal of Clinical Psychiatry 68: 1776–84.
World Health Organization (1992) Tenth Revision of the International Classification of Diseases and Related Health Problems (IDC-10). WHO.
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BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
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Adult attention-deficit hyperactivity disorder and bipolar disorder

  • Andrew Gleason and David Castle
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