Elsevier

Biological Psychiatry

Volume 58, Issue 7, 1 October 2005, Pages 554-561
Biological Psychiatry

Advances in the neurobiology of pediatric bipolar disorder
Psychopathology in the Offspring of Parents with Bipolar Disorder: A Controlled Study

https://doi.org/10.1016/j.biopsych.2005.06.010Get rights and content

Background

To examine the risk for psychopathology in offspring at risk for bipolar disorder and the course of psychiatric disorders in these youth.

Methods

Using structured diagnostic interviews (Structured Clinical Interview for DSM-IV [SCID] and Kiddie Schedule for Affective Disorders and Schizophrenia [K-SADS]), psychiatric diagnoses of 117 nonreferred offspring of parents with diagnosed bipolar disorder were compared with those of 171 age- and gender-matched offspring of parents without bipolar disorder or major depression.

Results

Compared with offspring of parents without mood disorders, high-risk youth had elevated rates of major depression and bipolar disorder, anxiety, and disruptive behavior disorders. High-risk offspring also had significantly more impaired Global Assessment of Functioning (GAF) scores, higher rates of psychiatric treatment, and higher rates of placement in special education classes. Disruptive behavior disorders, separation anxiety disorder, generalized anxiety disorder (GAD), social phobia, and depression tended to have their onset in early or middle childhood, whereas bipolar disorder, obsessive-compulsive disorder (OCD), panic disorder, and substance use disorder had onset most frequently in adolescence.

Conclusions

These findings support the hypothesis that offspring of parents with bipolar disorder are at significantly increased risk for developing a wide range of severe psychiatric disorders and accompanying dysfunction. Early disruptive behavior and anxiety disorders, as well as early-onset depression, may be useful markers of risk for subsequent bipolar disorder in high-risk samples.

Section snippets

Participants

Participants were 117 nonreferred offspring of 88 parents with bipolar disorder (hereafter referred to as high-risk offspring) and 171 comparison offspring of parents without bipolar disorder or major depression. Parents with bipolar disorder were recruited from among patients in treatment at the Harvard Bipolar Research Program (HBRP) at the Massachusetts General Hospital. Parents were informed of the study via advertisements in the waiting room and letters to clinicians and contacted the

Demographic Variables

Demographic variables are displayed in Table 1. There were no differences between the high-risk and comparison offspring in mean age, gender, ethnicity, or socioeconomic status (SES). There was a difference between the groups in the rates of family intactness (p < .05). Only 66.4% of high-risk offspring lived with both biological parents, compared with 91.8% of comparison offspring. In the high-risk group, 71.5% of affected parents were diagnosed with bipolar I, and 27.5% were diagnosed with

Discussion

This study examined the prevalence of psychiatric disorders in a large sample of offspring of parents with and without bipolar disorder. Compared with offspring of parents without mood disorders, high-risk youth had elevated rates of unipolar and bipolar mood disorders, anxiety, and disruptive behavior disorders. High-risk offspring also had significantly more impaired GAF scores and higher rates of placement in special education classes. These findings support the hypothesis that offspring of

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