OK: I was wrong--I guess I thought the ideas of mania and ADHD seemed too apparently coincidental but I found the info below (it doesn't sound like it's a strong relation and it may be no more than might be expected in the general public, that part is not clear):
From: http://www.nimh.nih.gov/publicat/bipolarresfact.cfm Co-occurring Illnesses The most common co-occurring illnesses among people with bipolar disorder are substance abuse disorders. Approximately 60 percent of people with bipolar disorder have drug and/or alcohol abuse or dependence problems � the highest rate across all patients with major psychiatric illnesses.(24) Research suggests that many factors likely contribute to these substance abuse problems, including self-medication of symptoms, mood symptoms either initiated or perpetuated by substance abuse, and risk factors that may influence the occurrence of both disorders.(25) A review of multiple research studies revealed several factors that increase the risk for co-occurring substance use among individuals with bipolar disorder, including early age of illness onset, family history of substance use disorders, and presence of mixed symptoms.(26) A current NIMH-funded study is investigating how substance abuse affects the frequency, duration, and severity of episodes in people with bipolar disorder.(27) Better understanding of the relationship between substance use and bipolar disorder will help improve both treatment and preventive interventions for co-occurring substance use, leading to better mental health outcome. Other research has indicated that certain anxiety disorders may co-occur with bipolar disorder. In one recent NIMH-supported study of post-traumatic stress disorder (PTSD) in people with bipolar disorder or schizophrenia, almost all patients reported having experienced at least one traumatic event in their lifetime.(28) While 43 percent of study participants met criteria for PTSD, only two percent had the diagnosis listed in their medical charts. The results suggest that PTSD commonly co-occurs with severe mental disorders. Routine screening for PTSD during medical visits would lead to improved diagnosis and treatment of this anxiety disorder, thus allowing the other co-occurring illness � bipolar disorder, schizophrenia, etc. � to be more effectively treated. Another NIMH-funded study found a high co-occurrence of both PTSD and obsessive- compulsive disorder (OCD) among patients with bipolar disorder across a 12- month period.(29) While the course of PTSD was independent of the mood disorder, the course of OCD frequently waxed and waned along with mood episodes. More research is needed to determine the nature of this apparent connection between OCD and bipolar disorder in some patients. Children and Adolescents Both children and adolescents can develop bipolar disorder. NIMH research efforts are attempting to clarify the diagnosis, course, and treatment of bipolar disorder in youth. Evidence suggests that bipolar disorder beginning in childhood or early adolescence may be a different, possibly more severe form of the illness than older adolescent- and adult-onset bipolar disorder.(30) When the illness begins before or soon after puberty, it is often characterized by a continuous, rapid-cycling, irritable, and mixed symptom state that may co-occur with disruptive behavior disorders, particularly attention deficit hyperactivity disorder (ADHD) or conduct disorder (CD), or may have features of these disorders as initial symptoms. In contrast, later adolescent- or adult- onset bipolar disorder tends to begin suddenly, often with a classic manic episode, and to have a more episodic pattern with relatively stable periods between episodes. There is also less co-occurring ADHD or CD among those with later onset illness. Findings from one NIMH-supported study suggest that the illness may be at least as common among youth as among adults. In this study, one percent of adolescents ages 14 to18 were found to have met criteria for bipolar disorder or cyclothymia in their lifetime.(31) In addition, close to six percent of adolescents in the study had experienced a distinct period of abnormally and persistently elevated, expansive, or irritable mood even though they never met full criteria for bipolar disorder or cyclothymia. Compared to adolescents with a history of major depressive disorder and to a never-mentally-ill group, both the teens with bipolar disorder and those with subclinical symptoms had greater functional impairment and higher rates of co-occurring illnesses (especially anxiety and disruptive behavior disorders), suicide attempts, and mental health services utilization. The study highlights the need for improved recognition, treatment, and prevention of even the milder and subclinical cases of bipolar disorder in adolescence. Bipolar disorder in children and adolescents has been difficult to recognize and diagnose because it does not fit precisely the symptom criteria established for adults, and because its symptoms can resemble or co-occur with those of ADHD and CD. In addition, symptoms of bipolar disorder may be initially mistaken for normal emotions and behaviors of children and adolescents. But unlike normal mood changes, bipolar disorder significantly impairs functioning in school, with peers, and at home with family. Although research in adults indicates that the essential treatment for bipolar disorder is the use of appropriate doses of mood stabilizing medications, few studies of the safety and efficacy of these drugs have been conducted in children and adolescents. NIMH is attempting to fill the current gaps in treatment knowledge with carefully designed studies. Data from adults do not necessarily apply to younger patients, because the differences in development may have implications for treatment efficacy and safety. Thus, research in children and adolescents is needed to properly guide clinicians, patients, and families. Current multi-site studies funded by NIMH are investigating the value of long- term treatment with lithium and other mood stabilizers in preventing recurrence of bipolar disorder in adolescents.(32), (33), (34) Specifically, these studies aim to determine how well lithium and other mood stabilizers prevent recurrences of mania or depression and control subclinical symptoms in adolescents; to identify factors that predict outcome; and to assess side effects and overall adherence to treatment. Another NIMH-funded study is evaluating the safety and efficacy of valproate for treatment of acute mania in children and adolescents, and also is investigating the biological correlates of treatment response.(35) Other NIMH-supported investigators are studying the effects of antidepressant medications in the treatment of the depressive phase of bipolar disorder in youth.(36) Quoting "Annette Taylor, Ph. D." <[EMAIL PROTECTED]>: > Hi Rob: > > I can address some of point #2, unfortunately I don't have the exact answer > to > your question. > > I am positive that ADHD is comorbid with out anxiety-related disorders such > as > OCD and Tourette's Syndrome. I believe the connection relates to a genetic > predisposition towards neurotransmitter control of inhibition of behavior. > > As for a relation to bipolar I would only be able to speculate but given my > knowledge of neurotransmitters--which is decided not great, but not nil > either, > I would be surprised. Then again, maybe there are components that are not > biologically based with these disorders. > > Annette > > Quoting Rob Weisskirch <[EMAIL PROTECTED]>: > > > TIPSfolk, > > > 2. Is there a relationship between bipolar disorder being co-morbid with > > ADHD in children? > > > > > Thanks, > > Rob > > > Annette Kujawski Taylor, Ph. D. Department of Psychology University of San Diego 5998 Alcala Park San Diego, CA 92110 [EMAIL PROTECTED] --- You are currently subscribed to tips as: [EMAIL PROTECTED] To unsubscribe send a blank email to [EMAIL PROTECTED]
