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It is increasingly appreciated that most patients with bipolar disorder do not have the classic features of "pure" euphoric mania and retarded depression, but rather have more atypical or mixed features, often accompanied by anxiety, agitation, and irritability. In addition, untreated attention deficit hyperactivity disorder can mimic the hyperactivity and distractibility symptoms of mania, which might influence global measures of outcome. Two recent studies examine the effects of comorbid ADHD and anxiety disorders in the course and outcome of bipolar illness.
To determine how comorbid ADHD affects treatment outcome, researchers reviewed charts from 42 adolescents hospitalized for mania and treated with lithium (n=29) or valproate (n=13). O…