Differential Treatment of Pediatric Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder

This article offers a pragmatic model of conceptualizing attention deficit hyperactivity disorder and pediatric bipolar disorder when they present alone, together, or as overlapping subsyndromes. Evidence-based findings from the US Food and Drug Administration-approved medications and randomized controlled trials of psychotherapy are quilted together to design a personalized treatment model. The treatment paradigm consists of an "ABCD" model of components: (A) Assessment of psychopathology toward individual diagnosis or comorbidity, (B) Brain circuitry function offering explanatory power for the phenomenology that includes affective and cognitive domain difficulties common in both the disorders, (C) Chemical imbalance addressed through pharmacotherapy for mania, mixed mania, depression, and attention deficit hyperactivity disorder, and (D) Delivery of proven psychosocial treatment coupled with addressing the key dynamics of interpersonal relationships. This intervention, based on empirical findings, is applicable to clinical practice. Identifying the neurocircuitry of cognitive and emotional impairment in pediatric bipolar disorder and attention-deficit/hyperactivity disorder guides the application of targeted treatments: a paradigm of translating science to clinical service.