Family functioning Deficits in bipolar disorder and ADHD in youth

Background: Rates of diagnosis and treatment for bipolar disorder (BD) in youth continue torise. Researchers and clinicians experience difficulty differentiating between BD in youth andother conditions that are commonly comorbid or share similar clinical features with BD,especially attention-deficit/hyperactivity disorder (ADHD). Comparative studies of thephenomenology and psychosocial correlates of these conditions help to address this. Familyfunctioning is an important topic for both BD and ADHD since both are associated withnumerous family-related deficits. One previous study suggested that manic/hypomanic youths’family functioning differed from ADHD and typically developing control (TDC) groups.However, many family functioning studies with BD and ADHD youth have methodologicallimitations or fail to use comprehensive, validated measures. Methods: This investigation usedadolescent report on the Family Assessment Device (FAD), based on the McMaster Model offamily functioning. Youth were recruited in BD (n=30), ADHD (n=36), and TDC (n=41)groups. Results: Groups were similar on most demographic variables, but The TDC groupscored somewhat higher than the others on IQ and socioeconomic status. FAD results indicatedthat BD and ADHD groups scored worse than TDC on the General Functioning and Roles scalesof the FAD. In addition, the BD group showed impairment on the Problem Solving scale relativeto TDC. Limitations: sample size, lack of parent report, ADHD comorbidity in BD group.Conclusions: Family functioning deficits distinguish both clinical groups from TDC, andproblem-solving dysfunction may be specific to BD. These findings may apply to treatmentmodels for both conditions.