Biological risk factors in pediatric bipolar disorder.
BACKGROUND
The current study attempted to determine whether neurodevelopmental and acquired brain abnormalities are more common in pediatric bipolar disorder (PBD).


METHODS
The study sample consisted of 98 subjects with a mean age of 11.5 +/- 3.3 years comprising three demographically matched groups: healthy controls (HC, n = 28), subjects with bipolar disorder - Type I (PBD, n = 37), and bipolar disorder - Type I combined with attention deficit hyperactivity disorder (PBD+ADHD, n = 33). Family history of PBD was determined using the Family History Screen. Additional measures were administered to assess the history on perinatal risk, development milestones, serious physical illnesses, and head injury.


RESULTS
Logistic regression showed that that family history and perinatal risk factors predicted the diagnosis of PBD. PBD diagnosis was 15 times higher among those with a family history of BD. Second, for every additional perinatal risk factor such as prenatal exposure to drugs or birth complications, the risk of having a PBD diagnosis increased more than six-fold.


CONCLUSIONS
Having a positive familial history of BD in a first degree relative and perinatal insults may elevate the risk for developing PBD. Presence of these risk factors, especially in the context of clinical signs of affect dysregulation, should alert clinicians to screen for PBD.
Pavuluri
Mani N
MN
Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA. mpavuluri@psych.uic.edu
Henry
David B
DB
Nadimpalli
Sruti S
SS
O'Connor
Megan Marlow
MM
Sweeney
John A
JA
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D010372:Pediatrics; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors