Psychiatric comorbidity and differential diagnosis in pediatric bipolar disorder

Bipolar disorder is frequently found in comorbidity with other psychiatric disorders in young and adult subjects. Psychiatric comorbidity has been reported play a significant role in the treatment and course of bipolar disorder in adult subjects. Meanwhile psychiatric comorbidity is a rule, rather than an exception, in pediatric bipolar disorder and has also a great impact on the treatment and course of the illness. Besides that, psychiatric comorbidity remains an important issue and difficulty while making diagnosis of bipolar disorder in young subjects. Meanwhile majority of symptoms of mania or hypomania are frequently encountered and even included among diagnostic characteristics of other childhood psychiatric disorders. Higher comorbidity and symptom overlapping with other psychiatric disorders is a major difficulty in the diagnosis and differentiation of bipolar disorder in young subjects. This review article aims to present and discuss psychiatric comorbidty and differential diagnosis in pediatric bipolar disorder in the light of current literature. A literature search was performed in Pubmed using different combinations of 'pediatric/juvenile bipolar disorder, bipolar disorder children/adolescents, bipolar disorder comorbidity/differential diagnosis, ADHD, disruptive behavior/anxiety/substance use/psychotic disorders, schizophrenia' and fulltext or abstract of relevant articles were reviewed. (Anatolian Journal of Psychiatry 2010; 11:177-184)