Nearly one-quarter of children with attention-deficit/hyperactivity disorder have or will develop bipolar disorder, according to a study in the August Journal of the American Academy of Child and Adolescent Psychiatry.

Of 140 children with attention-deficit/hyperactivity disorder studied over four years, 23 percent also had bipolar disorder, compared with about 2 percent of a group of children without ADHD. Eleven percent of the ADHD children had bipolar disorder when they were initially studied, and another 12 percent had bipolar disorder when studied again four years later, reports Joseph Biederman, M.D., of Massachusetts General Hospital.

The children with bipolar disorder were likely to be irritable and hyperactive, with simultaneous or rapid cycling between mania and depression, Biederman said.

The pattern is different from that in adults with bipolar disorder, who are more likely to swing between periods of euphoria and depression. In addition, many children with bipolar disorder had prolonged outbursts of aggression, sometimes called "affective storms," Biederman said.

Children who had both bipolar disorder and ADHD had more additional problems than those with ADHD alone. They were more likely to develop other psychiatric disorders such as depression or conduct disorders, more likely to require psychiatric hospitalization, and more likely to have social problems, Biederman reports.

Their ADHD was also more severe than in children without accompanying bipolar disorder.

(Psychiatric News, October 18, 1996)