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We included original papers on patients \u226418\u2009years with primary PBD and any comorbid psychiatric disorder, diagnosed according to a validated diagnostic tool. Risk of bias of the individual studies was assessed using the STROBE checklist. We calculated weighted means to assess the comorbidity prevalence. The review complied with PRISMA statement guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty studies with a total study population of 2722 patients with PBD were included (mean age\u2009=\u200912.2\u2009years). We found an overall high prevalence of comorbidity in patients with PBD. The most common comorbidities were attention\u2010deficit\u2010hyperactivity disorder (ADHD) (60%) and oppositional defiant disorder (ODD) (47%). Anxiety disorders, obsessive\u2013compulsive disorder, conduct disorder, tic disorders and substance\u2010related disorders affected between 13.2% and 29% of patients, while one in 10 had comorbid mental retardation or autism spectrum disorder (ASD). The prevalence of comorbid disorders was lower in studies that assessed the current prevalence in patients in full or partial remission. General functioning was overall not specifically decreased in patients with comorbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Comorbidity across a broad range of disorders was high in children diagnosed with PBD, especially regarding ADHD, ASD, behavioral and anxiety disorders including OCD. Future original studies should assess current prevalence of comorbidities in patients with PBD who are in remission to obtain more reliable estimates of psychiatric comorbidity in this patient group. The review highlights the clinical and scientific importance of comorbidity in PBD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13548","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T22:09:42Z","timestamp":1679350182000},"page":"110-132","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Psychiatric comorbidity in patients with pediatric bipolar disorder \u2013 A systematic review"],"prefix":"10.1111","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2675-464X","authenticated-orcid":false,"given":"Anne Mette","family":"Fahrendorff","sequence":"first","affiliation":[{"name":"Copenhagen Affective Disorder Research Center (CADIC) Psychiatric Centre Copenhagen, Mental Health Services Capital Region  Copenhagen Denmark"},{"name":"Child and Adolescent Mental Health Center Copenhagen University Hospital \u2013 Mental Health Services CPH  Copenhagen 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