Risk for emerging bipolar disorder, variants, and symptoms in children with attention deficit hyperactivity disorder, now grown up

Figure 1 Attention deficit hyperactivity disorder and local normative comparison group in relation to the relative proportion which represents the ratio of pathognomonic mania - the ratio of non- specific mania across all study subjects. Positive score 0 to +1.0 is associated with more PM than NSM. Negative score -1.0 to 0 is as associated with more NSM than PM. Entire Model was significant RRM (df 3, 2523; F = 20.1; P≤ 0.0001). All Variables (Group status, assessments time, and the changes of group status over time) were linked to RP changes (effect of Groups Status: F = 39.9; P≤ 0.0001- effect of Time: F = 14.7; P≤ 0.0001, and the interaction of Group × Time: F = 12.1 P≤ 0.0005). ADHD patients started with a preponderance of NSM over PM symptoms and the LNCG with a preponderance of PM over NSM symptoms, but the ratios converged over time. RP: Relative proportion; PM: Pathognomonic mania; NSM: Non- specific mania; ADHD: Attention deficit hyperactivity disorder; LNCG: Local normative comparison group.

Figure 2 Group (The Irritability Criterion with irritability vs No irritability) in relation to relative proportion of Pathognomonic Mania Ratio - Non-Specific Mania Ratio: Positive score 0 to +1. 0 links irritability to pathognomonic mania rather than non- specific mania and negative score -1.0 to 0 links the irritability status with non- specific mania rather than pathognomonic mania: Entire Model Random Regression Methods (df 3, 2523; F = 17.7; P < 0.0001). All Variables (Group status, assessments time, and the changes of group status over time) were linked to RP changes (effect of Irritability Status: F = 27.3; P < 0.0001; effect of Time: F = 32.5; P < 0.0001, and interaction of Irritability × Time: F = 4.3; P < 0.04). Irritability is linked at all time points with greater NSM than PM, and the linkage increases over time. Yes: Irritability present; No: Irritability not present. RP: Relative proportion; PM: Pathognomonic mania; NSM: Non- specific mania; ADHD: Attention deficit hyperactivity disorder; LNCG: Local normative comparison group; RRM: Random regression methods.