Joseph Biederman

Joseph Biederman (29 September 1947 – 5 January 2023) was Chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at the Massachusetts General Hospital and a professor of psychiatry at Harvard Medical School.

Biederman was board-certified in general and child psychiatry.

In 1986, Weller et al.

searched the literature of case reports describing children with severe psychiatric symptoms.

Of 157 such cases, 24% had childhood onset bipolar disorder.

This review suggested that juvenile mania may be common among referred children with severe psychopathology but that it may be difficult to diagnose.

This early work led to systematic studies by Biederman and others which showed that childhood onset bipolar disorder was more common than originally believed, especially among children with attention deficit hyperactivity disorder or conduct disorder.

Childhood onset bipolar disorder is now recognized by the American Academy of Child and Adolescent Psychiatry as a valid disorder as indicated by the publication of a practice parameter for diagnosing and treating bipolar disorder in children.

For many years the secondary prevention of bipolar disorder had been stymied by diagnostic uncertainties, especially its diagnostic criterion overlap with attention deficit hyperactivity disorder (ADHD).

These uncertainties made it difficult for clinicians to identify children with the disorder leading to delays and failures to treat the disorder.

To deal with this problem, Biederman began a program of research aimed at clarifying the diagnosis and better understanding its etiologic links with other disorders.

In an initial study, he and his mentees examined the prevalence and clinical features of childhood onset bipolar disorder in clinically referred children.

The sample consisted of all children, 12 years or younger, who had been consecutively referred to Biederman's pediatric psychopharmacology clinic since 1991.

Sixteen percent of 262 consecutive referrals met criteria for bipolar disorder.

Their bipolar disorder was chronic, severe and impairing in multiple domains of functioning (psychopathology, cognitive impairment and social disability).

All but one of the bipolar disorder children had a severe ADHD syndrome prior to the onset of mania.

Notably, symptom overlap analyses showed that this high rate of comorbidity was not due to diagnostic criteria shared by the two disorders.

Using the same sample, Biederman evaluated the ability of the Child Behavior Checklist (CBCL) to identify children with bipolar disorder.

His results showed excellent correspondence between the clinical scales of the CBCL and DSM-III-R diagnoses of bipolar disorder.

The excellent correspondence between clinical diagnoses and CBCL scales reflecting content congruent dimensions suggests that the CBCL could be a useful screening instrument to help identify mania and its associated comorbid conditions in referred children.

Because other research groups replicated his findings, they now provide a simple method for pediatricians and child psychiatrists to screen for bipolar disorder in their practices.

Prior work suggested that there may be a familial link between ADHD and bipolar disorder.

However, these prior studies had not explored the nature of this familial link.

Thus, Biederman sought to clarify the familial relationship between ADHD and bipolar disorder by testing competing hypotheses, based in part on models of familial transmission.

According to the New York Times, between 1994 and 2003, there was a controversial 40-fold increase in the diagnosis of pediatric bipolar disorder.

Although Biederman was one of the first to systematically study childhood onset bipolar disorder, the existence of bipolar disorder in childhood had been shown by many prior reports.

In 1995, Biederman was inducted into the CHADD Hall of Fame.

He was awarded the 2021 World Federation of ADHD Gold Medal Award for lifetime contributions to the field of ADHD.

In 2023, he was awarded the Lifetime Achievement Award of the American Professional Society of ADHD and Related Disorders.

During his lifetime, he was awarded over 15 million dollars in grant funding from the National Institutes of Health to support his research into the nature, causes and treatment of mental health disorders in youth.

Described as "one of the world's most influential child psychiatrists", Biederman published hundred of papers on attention-deficit hyperactivity disorder (ADHD) and ranks as one of the most-cited researchers on the subject.

He was one of the first to systematically study the co-occurrence of ADHD with mood, anxiety and substance use disorders.

His work showed that these disorders were common among ADHD patients.

Biederman also completed the first large scale case-control family studies of ADHD.

Biederman also led studies concluding that a substantial minority of children diagnosed with ADHD actually had pediatric bipolar disorder.

This theory was proposed at a time when it was unheard for young children to be diagnosed with bipolar disorder, which is characterized by severe mood Swings.

From 2019 to 2022, his citation metrics placed him in the top 0.01% of scientists across all fields.

His research was and is highly cited: Biederman had lifetime h-index of 121, which is one of the highest in the field of mental health.

These metrics indicate that his publications have had a substantial impact on the field. Although his biggest focus was on attention-deficit/hyperactivity disorder (ADHD) in youth and adults, he also studied obsessive-compulsive disorder, bipolar disorder, tic disorders, depression, and substance use disorders in youth.

Due to this work, he is regarded as the father of pediatric psychopharmacology.