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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.


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.