Clinical and Genetic Correlates of Bipolar Disorder With Childhood-Onset Attention Deficit Disorder

Overview

Journal Front Psychiatry

Specialty Psychiatry

Date 2022 May 2

PMID 35492709

Authors

Nicolas A Nunez

Brandon J Coombes

Francisco Romo-Nava

David J Bond

Jennifer Vande Voort

Paul E Croarkin

Nicole Leibman

Manuel Gardea Resendez

Marin Veldic

Hannah Betcher

Balwinder Singh

Colin Colby

Alfredo Cuellar-Barboza

Miguel Prieto

Katherine M Moore

Aysegul Ozerdem

Susan L McElroy

Mark A Frye

Joanna M Biernacka

Affiliations

Soon will be listed here.

Abstract

Background: Bipolar disorder (BD) with co-occurring attention deficit-hyperactivity disorder (ADHD) is associated with an unfavorable course of illness. We aimed to identify potential clinical and genetic correlates of BD with and without ADHD.

Methods: Among patients with BD ( = 2,198) enrolled in the Mayo Clinic Bipolar Biobank we identified those with ADHD diagnosed in childhood (BD+cADHD; = 350), those with adult-onset attention deficit symptoms (BD+aAD; = 254), and those without ADHD ( = 1,594). We compared the groups using linear or logistic regression adjusting for age, sex, and recruitment site. For genotyped patients ( = 1,443), logistic regression was used to compare ADHD and BD polygenic risk scores (PRSs) between the BD groups, as well as to non-BD controls ( = 777).

Results: Compared to the non-ADHD BD group, BD+cADHD patients were younger, more often men and had a greater number of co-occurring anxiety and substance use disorders (all < 0.001). Additionally, BD+cADHD patients had poorer responses to lithium and lamotrigine ( = 0.005 and = 0.007, respectively). In PRS analyses, all BD patient subsets had greater genetic risk for BD and ADHD when compared to non-BD controls ( < 0.001 in all comparisons). BD+cADHD patients had a higher ADHD-PRS than non-ADHD BD patients ( = 0.012). However, BD+aAD patients showed no evidence of higher ADHD-PRS than non-ADHD BD patients ( = 0.38).

Conclusions: BD+cADHD was associated with a greater number of comorbidities and reduced response to mood stabilizing treatments. The higher ADHD PRS for the BD+cADHD group may reflect a greater influence of genetic factors on early presentation of ADHD symptoms.

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