Affiliation:
1. IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiat., Calambrone (Pisa), Italy
2. Department of
Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Abstract
Background:
Bipolar Disorder (BD) is a highly comorbid condition, and rates of cooccurring
disorders are even higher in youth. Comorbid disorders strongly affect clinical presentation,
natural course, prognosis, and treatment.
Method:
This review focuses on the clinical and treatment implications of the comorbidity between
BD and Attention-Deficit/Hyperactivity Disorder, disruptive behavior disorders (Oppositional Defiant
Disorder and/or Conduct Disorder), alcohol and substance use disorders, Autism Spectrum Disorder,
anxiety disorders, Obsessive-Compulsive Disorder, and eating disorders.
Results:
These associations define specific conditions which are not simply a sum of different clinical
pictures, but occur as distinct and complex combinations with specific developmental pathways
over time and selective therapeutic requirements. Pharmacological treatments can improve these
clinical pictures by addressing the comorbid conditions, though the same treatments may also worsen
BD by inducing manic or depressive switches.
Conclusion:
The timely identification of BD comorbidities may have relevant clinical implications
in terms of symptomatology, course, treatment and outcome. Specific studies addressing the pharmacological
management of BD and comorbidities are still scarce, and information is particularly
lacking in children and adolescents; for this reason, the present review also included studies conducted
on adult samples. Developmentally-sensitive controlled clinical trials are thus warranted to
improve the prognosis of these highly complex patients, requiring timely and finely personalized
therapies.
Publisher
Bentham Science Publishers Ltd.
Subject
Pharmacology (medical),Psychiatry and Mental health,Neurology (clinical),Neurology,Pharmacology,General Medicine
Cited by
5 articles.
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