title: Comorbidity with ADHD decreases response to pharmacotherapy in children and adolescents with acute mania: evidence from a metaanalysis.
abstract: OBJECTIVE
  To assess whether comorbid attention-deficit hyperactivity disorder (ADHD) influences response to treatment in young patients with acute mania.
  
  
  METHODS
  We conducted a metaanalysis of 5 open trials of 100, 35, 41, 60, and 37 children and adolescents. The pooled group included 273 children and adolescents with bipolar disorder (BD), divided into 2 subgroups: those with (n = 132), and those without (n = 141), ADHD comorbidity.
  
  
  RESULTS
  There was a moderate and significant reduction in relative risk (RR) favouring treatment response in children and adolescents with BD but without ADHD comorbidity (RR 0.822; 95% CI, 0.69 to 0.97; P = 0.021). The negative effect of ADHD comorbidity on treatment response was more significant in studies including adolescents only or subjects with BD I only.
  
  
  CONCLUSIONS
  These findings suggest that children and adolescents with BD and ADHD tend to be less responsive to drugs used in treatment of acute mania.
authors.affiliation: Department of Child and Adolescent Psychiatry, AP-HP, Hôpital Pitié-Salpétrière, Université Pierre et Marie Curie, Paris, France.
authors.forename: Angèle
authors.initials: A
authors.lastname: Consoli
authors.forename: Anissa
authors.initials: A
authors.lastname: Bouzamondo
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Guilé
authors.forename: Philippe
authors.initials: P
authors.lastname: Lechat
authors.forename: David
authors.initials: D
authors.lastname: Cohen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D006801:Humans; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D011619:Psychotropic Drugs