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Course #: APSARDCE101
APSARD Newsletter ADHD and Comorbidity: Bipolar Disorder, Depression and ADHD

Publication Date: 2011
Lenard A. Adler, MD; ;Andrew Alan Nierenberg, MD; Vatsal Thakkar, MD; Betsy Busch, MD, FAAP; & Ron Gasbarro, PharmD

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Material Includes Online Newsletter and Test

About the Author

Lenard A. Adler, MD Departments of Psychiatry and Child and Adolescent Psychiatry New York University School of Medicine and VA Harbor Healthcare System New York, New York since 1995. He is also Associate Professor of Psychiatry and Child and Adolescent at the NYU School of Medicine. He obtained a BA in Economics from the College of Arts and Sciences at Cornell University in 1978. He earned his MD from Emory University School of Medicine in 1982, and went on to serve an internship in Medicine, Neurology, and Psychiatry, followed by a residency in Psychiatry, acting as Chief Resident from 1983 to 1986, at NYU School of Medicine. He has been interviewed numerous times in national media venues, including 60 Minutes and the Today Show, as well as The New York Times, USA Today and U.S. News & World Report, discussing his treatment methods for adults with ADHD.

Andrew Alan Nierenberg, MD graduated from the Albert Einstein College of Medicine of Yeshiva University, Bronx, New York. He did his residency in psychiatry at New York University/Bellevue Hospital in New York City, where he became a chief resident, and then went on as a Robert Wood Johnson Clinical Scholar at Yale University to study clinical epidemiology. He continued his trek north to join the faculty at Harvard, and then to direct the Affective Disorders Outpatient Unit at McLean Hospital. Dr. Nierenberg then joined the Psychopharmacology Unit at Massachusetts General Hospital in Boston in 1992 where he is currently Associate Director of the Depression Clinical and Research Program, Medical Director of the Bipolar Programs, and Associate Professor of Psychiatry at Harvard Medical School. His primary interests are treatment resistant depression, management of antidepressant side effects, the longitudinal course of affective disorders, and pharmacoepidemiology.

Vatsal Thakkar, MDis the Director of the NYU GME Wellness Team where he is on hand to perform evaluations and treatment for NYU resident physicians with mental health needs. He is also the Clinical Director for the NYU Mental Health & Addictive Disorders Research Program located at the Manhattan VA Medical Center. He also runs a private practice. Dr. Thakkar’s medical specialties include attention deficit disorder, psychopharmacology, and affective and anxiety disorders. His medical interests include adult ADHD, treatment-refractory depression, occupational and workplace psychiatry, and physician wellness

Betsy Busch, MD, FAAPis a pediatrician and Board-certified subspecialist in Developmental-Behavioral Pediatrics. She is an Associate Clinical Professor of Pediatrics at the Tufts University School of Medicine. Her research and clinical work has focused on children and adolescents with learning and attentional disorders. Now in private practice, she previously served as the founding Clinical Director of the Center for Children with Special Needs at Tufts Medical Center, a multidisciplinary program for the evaluation of children and adolescents with neurodevelopmental disorders. In addition to her clinical work with children, adolescents and young adults with ADHD and its co-morbid disorders, Dr. Busch consults with a variety of corporations, private organizations and educational institutions. She has expertise in state-of-the-art, pharmacological and non-pharmacological treatments of patients with ADHD and its comorbidities; effective classroom teaching techniques; appropriate accommodations for the classroom/workplace for children, adolescents and adults with ADHD and other neurodevelopmental disorders; and evaluation of competence and mastery in children and adults with learning and attentional disorders. Dr. Busch is the author of many articles and book chapters on ADHD and child development, is an invited reviewer for several scholarly journals, and is a nationally-known teacher

Ron Gasbarro, PharmD, MS Journ Medical Writer


1 hour CE/clock hours
CE Approval Statements (APA, ASWB, NBCC, NAADAC, and state boards)


APSARD Newsletter ADHD and Comorbidity: Bipolar Disorder, Depression and ADHD

Lenard A. Adler, MD; Andrew Alan Nierenberg, MD; Vatsal Thakkar, MD; Betsy Busch, MD, FAAP; & Ron Gasbarro, PharmD, MS Journ

This is a demo course that will introduce you to NACE courses and our online learning management system. You can earn one free CE hour by completing this course. Follow these simple steps:

1. Complete a CE User Profile to set up your CE User Account
2. Add the course to your cart below
3. Checkout
4. Study the online course materials
5. Take the online test
6. Print your certificate
7. View your certificate at any time by logging in to your account.

In this course we focus on ADHD and co-morbid mood disorders, major depression and bipolar disorder. You will meet Tammy, a 34-year old teacher. Her case study highlights the complexities of treating comorbid bipolar disorder and ADHD. Our lead story explores whether ADHD and bipolar are in fact comorbid or whether one is a subtype of the other. Also, you can find out how adverse childhood disorders affect adult mental and physical health, and how depression is treated around the world with efforts to standardize international treatment guidelines.

Learning Objectives
Upon completion of this course, learners should be able to:

  1. Describe how symptoms of ADHD may be present in other psychiatric disorders, such as bipolar disorder, and that such comorbidities warrant an initial therapeutic strategy based on the most impairing condition.
  2. Recognize that most children and adults with ADHD also have a comorbid psychiatric condition
  3. Explain the need for international guidelines for treating depression using the most effective therapeutic agents indicated for that disorder
  4. Extrapolate adverse childhood experiences to both psychiatric and somatic abnormalities in later life and understand that, by identifying the occurrence of such experiences, the sequelae of these incidents can be controlled and/or minimized


Difficulty Level: Intermediate to Advanced


Conflicts of Interest: Lenard Adler, MD has the following relationships to disclose: consultant for Shire Pharmaceuticals, Alcobra, Astra-Zeneca, Major League Baseball Players Association and an inventor and receives royalties for NYU School of Medicine. Conducts sponsored research for Shire Pharmaceuticals and is on the advisory board for Astra-Zeneca.

Andrew Nierenberg, MD has the following relationships to disclose. Consultant to the Appliance Computing Inc., Brandeis University, Astra Zeneca, Brain Cells, Inc, Dianippon Sumitomo/Sepracor, Johnson and Johnson, Labopharm, Merck, Methylation Science, Novartis, PGx Health, Shire, Schering-Plough, Targacept, and Takeda/Lundbeck Pharmaceuticals. He received grant/research support through MGH from NIMH, PamLabs, Pfizer Pharmaceuticals, and Shire. He received honoraria from Belvior Publishing, Hillside Hospital, APSARD, American Society for Clinical Psychopharmacology, Columbia University, IMEDEX, ISBD, MJ Consulting, New York State, MBL Publishing, Physicians Postgraduate Press, SciMed, SUNY Buffalo, University of Wisconsin, and the University of Pisa. He is on the advisory boards of Appliance Computing, Inc., Brain Cells, Inc., Eli Lilly and Company, Johnson and Johnson, and Takeda/Lundbeck and Targacept. Dr. Nierenberg owns stock options in Appliance Computing, Inc. and Brain Cells, Inc. Through MGH, he is named for copyrights to the Clinical Positive Affect Scale and the MGH Structured Clinical Interview for the Montgomery Asberg Depression Scale exclusively licensed to the CTNI.

Vatsal Thakkar, MD has the following relationships to disclose: consultant to Practice Fusion, Inc. and Titan Pharmaceuticals.

Betsy Busch, MD, FAAP has the following relationships to disclose: Consultant and stock ownership for Ortho-McNeil-Janssen Pharmaceuticals; Speaker's Bureau for Shionogi Inc.; Faculty for Shire Pharmaceuticals; Ad Board for NextWave Pharmaceuticals.

Ron Gasbarro, PharmD, MS Journ has no relationships to disclose.

Harvey C. Parker, Ph.D., Activity Planning Committee, has the following relationship to disclose: co-owner of Specialty Press, Inc. and Health Link Systems, Inc.

Michelle Frisch, MPH, Activity Planning Committee, has no relationships to disclose.

Alan Goodstat, LCSW, Activity Planning Committee, has no relationships to disclose.