Psychopathology in the offspring of parents with bipolar disorder: a controlled study.
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.
Henin
Aude
A
Pediatric Psychopharmacology Unit and Harvard Bipolar Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02138, USA. ahenin@partners.org
Biederman
Joseph
J
Mick
Eric
E
Sachs
Gary S
GS
Hirshfeld-Becker
Dina R
DR
Siegel
Rebecca S
RS
McMurrich
Stephanie
S
Grandin
Louisa
L
Nierenberg
Andrew A
AA
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology / Q000523:psychology; D001714:Bipolar Disorder / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000523:psychology*; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D012307:Risk Factors; D012919:Social Behavior