Autism, ADHD and Bipolar Disorder
Research on ADHD and autism suggests that traditional bipolar disorder diagnoses may sometimes be flawed, with symptoms potentially better understood through a neurodiverse lens rather than strictly as bipolar disorder.
Overlapping Symptoms and Misdiagnosis
ADHD and bipolar disorder (BD) share overlapping symptoms such as impulsivity, distractibility, and mood instability, which can lead to diagnostic errors and ineffective treatment if not carefully differentiated (Barbosa & Guedes, 2022; Mucci et al., 2019). This overlap complicates the clinical picture, especially when ADHD persists into adulthood and co-occurs with BD (Mucci et al., 2019).
Neurodiversity Perspective
The neurodiversity paradigm views conditions like ADHD and autism as part of a spectrum of human diversity rather than disorders needing a cure. This perspective emphasises understanding these conditions as variations in functioning rather than pathologies (Bölte et al., 2021; Koi, 2021; Baron-Cohen, 2017). The neurodiversity framework could potentially offer a more accurate understanding of symptoms traditionally diagnosed as bipolar disorder, by recognising them as part of a broader spectrum of neurodevelopmental differences (Baron-Cohen, 2017; Fletcher‐Watson, 2022).
Diagnostic Challenges and Recommendations
There is a need for increased awareness and better diagnostic tools to differentiate between ADHD, autism, and bipolar disorder. Misdiagnosis is common, and a comprehensive clinical history focusing on neurodevelopmental aspects is crucial for accurate diagnosis (Barbosa & Guedes, 2022; Iyiola et al., 2022). The use of screening tools like the Autism Spectrum Quotient (AQ-10) is underutilised and could aid in identifying neurodiversity (Iyiola et al., 2022).
Conclusion
Research indicates that some symptoms traditionally diagnosed as bipolar disorder might be better understood through a neurodiverse framework, particularly in cases involving ADHD and autism. This approach could lead to more accurate diagnoses and effective treatments by recognising the spectrum of neurodevelopmental differences rather than strictly adhering to traditional diagnostic categories.
References
Barbosa, M., & Guedes, R. (2022). Adult attention-deficit/hyperactivity disorder and bipolar disorder: diagnostic and management challenges. European Psychiatry, 65, S466 – S467. https://doi.org/10.1192/j.eurpsy.2022.1185
Baron-Cohen, S. (2017). Editorial Perspective: Neurodiversity – a revolutionary concept for autism and psychiatry. Journal of child psychology and psychiatry, and allied disciplines, 58 6, 744-747. https://doi.org/10.1111/jcpp.12703
Bölte, S., Lawson, W., Marschik, P., & Girdler, S. (2021). Reconciling the seemingly irreconcilable: The WHO’s ICF system integrates biological and psychosocial environmental determinants of autism and ADHD. BioEssays, 43. https://doi.org/10.1002/bies.202000254
Fletcher‐Watson, S. (2022). Transdiagnostic research and the neurodiversity paradigm: commentary on the transdiagnostic revolution in neurodevelopmental disorders by Astle et al. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 63, 418 – 420. https://doi.org/10.1111/jcpp.13589
Iyiola, J., Lewis, F., Glavin, S., & Shukla, R. (2022). Neurodiversity Within an Adult Home Treatment Team in Newham, London. BJPsych Open, 8, S164 – S164. https://doi.org/10.1192/bjo.2022.461
Koi, P. (2021). Genetics on the neurodiversity spectrum: Genetic, phenotypic and endophenotypic continua in autism and ADHD. Studies in history and philosophy of science, 89, 52-62. https://doi.org/10.1016/j.shpsa.2021.07.006
Mucci, F., Avella, M., & Marazziti, D. (2019). ADHD With Comorbid Bipolar Disorders: A Systematic Review of Neurobiological, Clinical And Pharmacological Aspects Across The Lifespan. Current medicinal chemistry. https://doi.org/10.2174/0929867326666190805153610