Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

BD Course Strongly Affected by Comorbid Disorders

J Affect Disord; ePub 2018 Dec 25; Weintraub, et al

The course of bipolar disorder (BD) in adolescents is strongly affected by comorbid disorders, according to a recent study. 145 adolescents with BD-I or BD-II disorder were randomly assigned to family-focused therapy (FFT-A) or a brief psychoeducational therapy (enhanced care [EC]) and followed over 2 years. Participants received pharmacotherapy for the study's duration. Researchers examined whether comorbid anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), and disruptive behavior disorders (DBDs; ie, oppositional defiant and conduct disorder) predicted the proportion of weeks that participants experienced mood symptoms during follow-up, and whether comorbid disorders moderated the effects of treatment assignment on mood symptoms and family conflict. They found:

  • Comorbid anxiety was associated with a greater proportion of weeks with depressive symptoms, more severe (hypo)manic symptoms during follow-up, and greater family conflict over the 2-year study.
  • Comorbid ADHD was associated with a greater proportion of weeks with (hypo)manic symptoms, more severe (hypo)manic symptoms, and greater family conflict.
  • Additionally, comorbid ADHD moderated the effects of psychosocial treatments on (hypo)manic symptoms and family functioning.
  • Comorbid DBDs were consistently associated with more severe depressive symptoms and greater family conflict throughout the study.


Weintraub MJ, Axelson DA, Kowatch RA, Schneck CD, Miklowitz DJ. Comorbid disorders as moderators of response to family interventions among adolescents with bipolar disorder. [Published online ahead of print December 25, 2018]. J Affect Disord. doi:10.1016/j.jad.2018.12.125.

This Week's Must Reads

Family Involvement in Veterans with Schizophrenia, Psychiatr Rehabil J; ePub 2019 Mar 28; Cohen, et al

Cognitive Training Program in Schizophrenia, Schizophr Res; ePub 2019 Mar 28; Mahncke, et al

Continuous Exercise & CI in Schizophrenia, Front Psychiatry; ePub 2019 Mar 13; Herbsleb, et al

MHC Risk Variants in Cortical Thickness, Brain Behav; ePub 2019 Mar 28; Tao, et al

Disclosing the Diagnosis of Schizophrenia, Int J Soc Psychiatry; ePub 2019 Mar 27; Setti, et al

Must Reads in Bipolar Disorder

BD Course Strongly Affected by Comorbid Disorders, J Affect Disord; ePub 2018 Dec 25; Weintraub, et al

Motor Activity, Energy, Mood, Sleep Examined in BD, JAMA Psychiatry; ePub 2018 Dec 12; Merikangas, et al

Differentiating Borderline Personality from BD, Compr Psychiatry; 2019 Jan; Balling, et al

Bipolar Diathesis in Major Depression Disorder , J Affect Disord; ePub 2018 Nov 2; Bennett, et al

Expressed Emotion Among Parents of Youths with BD, Psychiatry Res; 2018 Dec; Millman, Weintraub, et al