Psychiatric phenomenology of child and adolescent bipolar offspring.
OBJECTIVE
To establish prodromal signs of and risk factors for childhood bipolar disorder (BD) by characterizing youths at high risk for BD.


METHODS
Structured diagnostic interviews were performed on 60 biological offspring of at least one parent with BD. Demographics, family histories, and parental history of childhood disruptive behavioral disorders were also assessed.


RESULTS
Fifty-one percent of bipolar offspring had a psychiatric disorder, most commonly attention-deficit/hyperactivity disorder (ADHD), major depression or dysthymia, and BD. BD in offspring tended to be associated with earlier parental symptom onset when compared with offspring without a psychiatric diagnosis. Bipolar parents with a history of childhood ADHD were more likely to have children with BD, but not ADHD. Offspring with bilineal risk had increased severity of depressed and irritable mood, lack of mood reactivity, and rejection sensitivity, while severity of grandiosity, euphoric mood, and decreased need for sleep were not preferentially associated with such offspring.


CONCLUSIONS
Bipolar offspring have high levels of psychopathology. Parental history of early-onset BD and/or childhood ADHD may increase the risk that their offspring will develop BD. Prodromal symptoms of childhood BD may include more subtle presentations of mood regulation difficulties and less presence of classic manic symptoms.
Chang
K D
KD
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, CA 94305-5540, USA. kchang88@stanford.edu
Steiner
H
H
Ketter
T A
TA
D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000235:genetics; D001714:Bipolar Disorder / Q000150:complications / Q000453:epidemiology / Q000235:genetics / Q000523:psychology*; D002648:Child; D015897:Comorbidity; D005260:Female; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012494:Sampling Studies; D012737:Sex Factors