Parsing pediatric bipolar disorder from its associated comorbidity with the disruptive behavior disorders

Thomas J. Spencer, Joseph Biederman, Janet Wozniak, Stephen V. Faraone, Timothy E. Wilens, Eric Mick

Research output: Contribution to journalReview articlepeer-review

61 Scopus citations


The unique pattern of comorbidity found in pediatric mania greatly complicates accurate diagnosis, the course of the disorder, and its treatment. The pattern of comorbidity is unique by adult standards, especially its overlap with attention-deficit/hyperactivity disorder (ADHD), aggression, and conduct disorder. Clinically, symptoms of mania have been discounted as severe ADHD or ignored in the context of aggressive conduct disorder. This atypicality may lead to neglect of the mood component. The addition of high rates of additional disorders contributes to the severe morbidity, dysfunction, and incapacitation frequently observed in these children. A comprehensive approach to diagnostic evaluation is the keystone to establishing an effective treatment program because response to treatment differs with individual disorders. Recognition of the multiplicity of disorders guides therapeutic options in these often refractory conditions. What was previously considered refractory ADHD, oppositionality, aggression, and conduct disorder may respond after mood stabilization. We review these issues in this article.

Original languageEnglish
Pages (from-to)1062-1070
Number of pages9
JournalBiological Psychiatry
Issue number12
StatePublished - 15 Jun 2001
Externally publishedYes


  • Bipolar disorder
  • Child
  • Comorbidity


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