Does comorbid bipolar disorder increase neuropsychological impairment in children and adolescents with ADHD?

Abstract

Objective: To assess differences in executive functioning between children and adolescents with attention-deficit/hyperactivity disorder (ADHD) comorbid or not with bipolar disorder (BD), and to study the neuropsychological profile of subjects with the comorbidity in a clinical sample from a developing country. Method: Case-control study comparing 23 participants with BD + ADHD and 85 ADHD-only subjects aged 6 to 17 years old. Both groups were drug-free. Executive function domains were assessed with the Stroop Test, the Wisconsin Card Sorting Test, and the Continuous Performance Test II. Results: The group with juvenile BD + ADHD showed a significantly worse performance on the Stroop task, including time in color (p = 0.002), time in color-word (p , 0.001), interference, number or errors in color and color-word (p = 0.001), and number of errors in word cards (p = 0.028). No between-group differences were found in other tests. Conclusions: Our findings suggest that ADHD-only and ADHD + BD do not show differences in inhibitory control and set-shifting domains. However, children and adolescents with BD and comorbid ADHD show greater impairment in processing speed and interference control. This suggests a potentially higher impairment in the dorsolateral prefrontal cortex and may be a potential neuropsychological signature of juvenile BD comorbid with ADHD.

Affective Processing in Pediatric Bipolar Disorder and Offspring of Bipolar Parents

“…Another functional MRI (fMRI) study on affective processing in bipolar disorder showed that patients with BD and high-risk individuals displayed a stronger amygdala response than did healthy controls in response to fearful stimuli. Notably, the three groups did not differ in their ability to label face emotion (Olsavsky et al 2012). Thereore, the pattern of response to affective stimuli observed in our BD offspring may be the result of limbic hyperactivation.…”

“…Findings in this research field are mixed, as a recent study showed that children with BD performed as accurately as children with BD and/or comorbid ADHD symptoms (including children with ADHD only) on measures of sustained attention and response inhibition (Narvaez et al 2014). Because the latter study did not include a healthy control group it is, however, unknown whether the cognitive performance of these children was within or below standard average values.…”

Eating Disorders Impact on Vigilance and Decision Making of a Community Sample of Treatment Naive Attention-Deficit/Hyperactivity Disorder Young Adults

“…Results from studies evaluating how comorbid mental disorders influence cognitive functioning of ADHD have had varying results for children ( 14 , 15 ) and adults ( 16 , 17 ). Also, most studies have focused on anxiety and mood disorders.…”

Neuropsychological Profiles Correlated with Clinical and Behavioral Impairments in a Sample of Brazilian Children with Attention-Deficit Hyperactivity Disorder

“…It is well established that DLPFC and ACC are key impaired brain areas in ADHD ( 16 ). The most replicated alterations in childhood include significantly smaller volumes in the DLPFC, caudade, pallidum, corpus callosum, and cerebellum ( 17 ).…”