Abstract
In response to the article “Comorbidity and Phenomenology of Bipolar Disorder in Children With ADHD” by Serrano et al. published online in Journal of Attention Disorders on January 30, 2012 (DOI: 10.1177/1087054711427553) I would like to raise a number of issues.
I would like to raise certain issues.
Apart from studies from the United States, there is a large volume of research from India on comorbidity of ADHD in children and adolescents with bipolar disorder (BPD; Jaideep, Reddy, & Srinath, 2006; Jairam, Srinath, Girimaji, & Seshadri, 2004; Rajeev, Srinath, Girimaji, Seshadri, & Singh, 2004; Reddy & Srinath, 2000).
There was a study from the United Kingdom on the same topic where only one out of 200 ADHD patients was diagnosed with BPD (Hassan, Agha, Langley, & Thapar, 2011).
In the study by Birmaher et al. (2006), 25% of BPD-NOS (not otherwise specified) converted to BPD-1 and 5% converted to BPD-2. This detail is provided in the full text of the article. However, the figure of 25% is provided in the abstract of the article (Birmaher et al., 2006).
I am interested to know if the “and” rule or “or” rule was followed regarding items in which the child and parent reports differed. This has been shown to be an area of concern as following the “and” rule can lead to increased rates of comorbidity (Pliszka, 2003).
Details regarding history of stimulant use among the ADHD patients could have been provided as “behavioral sensitization” mechanism has been reported to account for earlier expression of BPD (DelBello et al., 2001; Soutullo et al., 2002).
It would be interesting to study the proportion of cases diagnosed to have BPD-NOS who will be diagnosed with the recently proposed “temper dysregulation disorder with dysphoria” by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V) childhood and adolescent disorders work group ((American Psychiatric Association DSM-5 Work Group, 2011).