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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.

Citation:

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.