Executive deficits in early onset bipolar disorder versus ADHD: Impact of processing speed and lifetime psychosis

• Published in: Clinical child psychology and psychiatry Vol. 18; no. 2; pp. 284 - 299
• Main Authors: Udal, Anne Helseth, Øygarden, Bjørg, Egeland, Jens, Malt, Ulrik Fredrik, Løvdahl, Hans, Pripp, Are Hugo, Grøholt, Berit
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.04.2013
• Subjects: Adolescent; Age of Onset; Attention Deficit Disorder with Hyperactivity - complications; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - psychology; Attention deficit hyperactivity disorder; Behavioral Symptoms - etiology; Bipolar affective disorder; Bipolar Disorder - complications; Bipolar Disorder - diagnosis; Bipolar Disorder - epidemiology; Bipolar Disorder - psychology; Child; Child Behavior; Child Development; Comorbidity; Early onset; Executive Function; Female; Humans; Intelligence Tests; Male; Outcome Assessment (Health Care); Psychiatric Status Rating Scales; Psychotic Disorders - diagnosis; Psychotic Disorders - etiology; Psychotic symptoms; ADHD; bipolar disorder; executive functions; psychosis; processing speed
• ISSN: 1359-1045; 1461-7021
• DOI: 10.1177/1359104512455181

Executive deficits are reported in both early onset bipolar disorder (BD) and attention-deficit hyperactivity disorder (ADHD), and controversies regarding comorbidity and symptom overlap have complicated the research on executive function in BD. Reports of the negative impact of executive difficulties on academic functioning indicate a need for a greater focus on executive difficulties in early onset psychiatric disorders. Executive function and processing speed in youths with BD (n = 4), ADHD (n = 26) and BD + ADHD (n = 13) were compared with controls (n = 69). All clinical groups demonstrated executive impairment. The combined group was most impaired. There were no significant differences between the groups. Executive deficit in the BD group was associated with a history of psychotic symptoms. The BD-nonpsychotic group was impaired only with regard to processing speed. Processing speed adjustment improved working memory and normalized interference control in both BD and ADHD. Conclusion: executive deficits in BD may be determined by a history of psychotic symptoms rather than by comorbid ADHD. Some aspects of executive problems appear speed-related.