For Immediate Release <WAP_BODY>DENVER/EWORLDWIRE/Sep. 27, 2005 --- Dr. William Niederhut, a Denver psychiatrist and Harvard Medical graduate, claims in a new book that many adults with bipolar disorders have ADHD and are suffering from an inherited disorder that he calls the Childhood-Onset Bipolar Attention-Deficit, or "COBAD," syndrome.

Full article
http://newsroom.eworldwire.com/view_release.php?id=12724

Ive said this before too....... but there is an evidenced based (research derived) "one way comorbidity" between kids with bipolar & ADHD....in that up to 97% (I've seen 92-97% for the range) of biploar kids also have ADHD....while the reverse isn't true.:)

Nice work.

That's fascinating. I've read that the median age for pediatric diagnosis of bipolar disorder is 15-19. What's your opinion on that?

Also if the median age is 15-19 for bi-polar what is there an established median age for pediatric ADD diagnosis?

And if so, if the median age for diagnosis of the two disorders is widely disparate and there is as you have mentioned a one-way co morbidity. What impact does that have on treatment for someone who is bi-polar but only diagnosed for AD/HUD.

Don't know off hand but Andi posted the same study that I just referred to.

It's in the Bipolar section of the Forum.

I also heard Russ present that at Door County in 2003.

The CEU CD that has those data is on my desk at work...lol.

I'll try and re-post that reference; as I've posted it once before, but that was quite some time ago.

You've done a very nice job of posting interesting topics.

It also shows how tough it is to stay on top of the research. If you slack off for any lenght of time, you can get left behind in a hurry.

If 98% of kids with Bipolar exhibit symptoms of ADHD, isn't it more accurate to simply say that the ADHD symptoms are symptoms of the Bipolar, rather than to make it a co-morbid diagnosis? Especially from a therapeutic view, while the stimulants useful for ADHD are ruled out immediately in Bipolar?

I'm no doctor Keith, but I read recently that sometimes AD/HD meds are used once bipolar symptoms are controlled. Sounds like a tricky balancing act to me.

It does sound risky, but I'm no expert on Bipolar disorders by any standard...I've only had occassion to study it twice, and then was more a cursory overview and a few case videos to teach what to look for in diagnostics, not therapy.

I do know that SSRIs are often contraindicated due to risk of triggering a manic episode...and if SSRIs do that, I can't imagine what a stimulant would do.

It is very tricky. While what you're suggesting would make sense Keith, they're considered separate disorders.

Again, the distinguishing features to look for are : 1) elevated mood (in this case it would be episodic);2) decreased need for sleep (as little as 2-3 hrs a night being enough); 3)flight of ideas ( racing thoughts)-as opposed to trouble concentrating;4)grandiosity (kid proclaims to be the world's greatest expert on whatever it is and proceeds to tell you how to do it); 5) hypersexualized behavior at an early age.

I've posted these before. There are no set number of these required to substantiate the diagnosis and the hypersexualized behavior is not strictly indicative of some type of abuse.

The 6th (and strictly anectodal at this point) is extreme / major destructiveness.

I'm no doctor Keith, but I read recently that sometimes AD/HD meds are used once bipolar symptoms are controlled. Sounds like a tricky balancing act to me.I went to my Pdoc yesterday, who decided to take me off of Stratera and treat me for BPD (bipolar disorder) I am hoping that will do the trick for me! I don't know if I will get back to the Stratera ADH shuffle, but for now I'll have to live with my add symptoms without the aid of meds...
I am tired of not being pinpointed one way or another, I know it is not the docs fault, but it gets old...:confused:

I went to my Pdoc yesterday, who decided to take me off of Stratera and treat me for BPD (bipolar disorder) I am hoping that will do the trick for me! I don't know if I will get back to the Stratera ADH shuffle, but for now I'll have to live with my add symptoms without the aid of meds...
I am tired of not being pinpointed one way or another, I know it is not the docs fault, but it gets old...:confused:
Mead,

My experience leads me to believe that you'll do much better on a mood-stabilizer than on Strattera if you're bipolar.

All those childhood things that everyone looks at now as signs ADHD, I always wrote off as bipolar disorder. Once I treated the mood, I managed quite well for over a decade. The new diagnosis and meds treated a decline in cognitive functioning (mostly my ability to force myself to read and understand boring material and working memory) that I've been experiencing the last few years, probably due to early pre-menopausal declines in horomones.

If it weren't for these cognitive problems, I wouldn't be suffering from the ADHD and wouldn't even realize it was a part of me. I can handle the craziness pretty well and, in fact, I like it. I just always thought it was my way of keeping "mania" going to avoid those downs. Now I know it's a different disorder. One is mood-related, the other involves cognitive functioning.

Just a note on the previous posts on the thread. The high comorbidity of bipolar and ADHD is not new. Most of the bipolars I know that were treated for something as children were originally diagnosed with ADHD either instead of or along with bipolar disorder. It's interesting. I wonder if it's related genetically; the heritability rate for bipolar is the highest of all the psychiatric disorders, but ADHD isn't far behind.

Hey barbyma, thanks for addressing my post. Yes you know, I have never been as closely diagnosed with either condition up until now...After years of thinking my problem is ADD, and recovering from D and A, finding someone willing to treat me for ADD which I tend to believe that is what I mostly inherited from my dad, and then realizing that even though I am mostly depressive, that I have periods of mania (which are not as obvious to me), it is a relief that someone is finally narrowing down my problems for me. I am really thaqnkful! I've lived most of my life with psychiatric disorders that, for one reason or another were not clear cut, all the others except for my obvious clinical depression...
It is a relief being 47 to have been diagnosed first with ADD, earlier this year, and now with bipolar, which I now see the patterns and the simptoms more clearly being masked by the depression...but first, by PTSD, Borderrline personality disorder (results of my being raped), then with a mask of a few years of drinking and drugging and numbing the mental pain...Then hitting bottom with depression, the loss of my first marriage, getting in recovery to deal with my obvious "problem", and then slowly but surely unmasking all the garbage to get to the root of my condition(s)...
I assure you it has been quite a journey for me, and I surprise myself at being still alive...
Thanks for having shared with me...
Peace,