Child comorbidity, maternal mood disorder, and perceptions of family functioning among bipolar youth.
OBJECTIVE
To examine the association between youth comorbid psychiatric disorders, maternal mood disorder, and perceptions of family cohesion and conflict among youth diagnosed with pediatric bipolar disorder (PBD).


METHODS
Three hundred eighty-nine bipolar youths and their parents completed a diagnostic interview and instruments assessing family psychiatric history and functioning. Family functioning was assessed with the Family Adaptability and Cohesion Scales-II and the Conflict Behavior Questionnaire.


RESULTS
The presence of a maternal mood disorder was associated with lower family cohesion. The presence of a youth externalizing disorder with or without a co-occurring anxiety disorder was also associated with lower family cohesion as well as higher family conflict. Furthermore, the negative relationship between maternal mood disorder and family functioning was stronger in the presence of a youth externalizing disorder.


CONCLUSIONS
Youth comorbidity and maternal mood disorders appear to be associated with worse family functioning among bipolar youths. Family-based treatments with bipolar youths may need to integrate treatment of youth comorbidity and address maternal mood disorder for optimal results.
Esposito-Smythers
Christianne
C
Drs. Esposito-Smythers, Valeri, Hunt, Leonard, Sindelar, and Keller are with the Department of Psychiatry, Brown Medical School, Providence, RI, and the Center for Alcohol and Addiction Studies, Bradley Hospital, Butler Hospital; Drs. Birmaher, Ryan, and Axelson and Ms. Chiappetta are with the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; and Dr. Strober is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles.. Electronic address: Christianne_Esposito@Brown.edu.
Birmaher
Boris
B
Drs. Esposito-Smythers, Valeri, Hunt, Leonard, Sindelar, and Keller are with the Department of Psychiatry, Brown Medical School, Providence, RI, and the Center for Alcohol and Addiction Studies, Bradley Hospital, Butler Hospital; Drs. Birmaher, Ryan, and Axelson and Ms. Chiappetta are with the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; and Dr. Strober is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles.
Valeri
Sylvia
S
Drs. Esposito-Smythers, Valeri, Hunt, Leonard, Sindelar, and Keller are with the Department of Psychiatry, Brown Medical School, Providence, RI, and the Center for Alcohol and Addiction Studies, Bradley Hospital, Butler Hospital; Drs. Birmaher, Ryan, and Axelson and Ms. Chiappetta are with the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; and Dr. Strober is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles.
Chiappetta
Laurel
L
Drs. Esposito-Smythers, Valeri, Hunt, Leonard, Sindelar, and Keller are with the Department of Psychiatry, Brown Medical School, Providence, RI, and the Center for Alcohol and Addiction Studies, Bradley Hospital, Butler Hospital; Drs. Birmaher, Ryan, and Axelson and Ms. Chiappetta are with the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; and Dr. Strober is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles.
Hunt
Jeffrey
J
Drs. Esposito-Smythers, Valeri, Hunt, Leonard, Sindelar, and Keller are with the Department of Psychiatry, Brown Medical School, Providence, RI, and the Center for Alcohol and Addiction Studies, Bradley Hospital, Butler Hospital; Drs. Birmaher, Ryan, and Axelson and Ms. Chiappetta are with the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; and Dr. Strober is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles.
Ryan
Neal
N
Drs. Esposito-Smythers, Valeri, Hunt, Leonard, Sindelar, and Keller are with the Department of Psychiatry, Brown Medical School, Providence, RI, and the Center for Alcohol and Addiction Studies, Bradley Hospital, Butler Hospital; Drs. Birmaher, Ryan, and Axelson and Ms. Chiappetta are with the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; and Dr. Strober is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles.
Axelson
David
D
Drs. Esposito-Smythers, Valeri, Hunt, Leonard, Sindelar, and Keller are with the Department of Psychiatry, Brown Medical School, Providence, RI, and the Center for Alcohol and Addiction Studies, Bradley Hospital, Butler Hospital; Drs. Birmaher, Ryan, and Axelson and Ms. Chiappetta are with the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; and Dr. Strober is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles.
Strober
Michael
M
Drs. Esposito-Smythers, Valeri, Hunt, Leonard, Sindelar, and Keller are with the Department of Psychiatry, Brown Medical School, Providence, RI, and the Center for Alcohol and Addiction Studies, Bradley Hospital, Butler Hospital; Drs. Birmaher, Ryan, and Axelson and Ms. Chiappetta are with the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; and Dr. Strober is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles.
Leonard
Henrietta
H
Drs. Esposito-Smythers, Valeri, Hunt, Leonard, Sindelar, and Keller are with the Department of Psychiatry, Brown Medical School, Providence, RI, and the Center for Alcohol and Addiction Studies, Bradley Hospital, Butler Hospital; Drs. Birmaher, Ryan, and Axelson and Ms. Chiappetta are with the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; and Dr. Strober is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles.
Sindelar
Holly
H
Drs. Esposito-Smythers, Valeri, Hunt, Leonard, Sindelar, and Keller are with the Department of Psychiatry, Brown Medical School, Providence, RI, and the Center for Alcohol and Addiction Studies, Bradley Hospital, Butler Hospital; Drs. Birmaher, Ryan, and Axelson and Ms. Chiappetta are with the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; and Dr. Strober is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles.
Keller
Martin
M
Drs. Esposito-Smythers, Valeri, Hunt, Leonard, Sindelar, and Keller are with the Department of Psychiatry, Brown Medical School, Providence, RI, and the Center for Alcohol and Addiction Studies, Bradley Hospital, Butler Hospital; Drs. Birmaher, Ryan, and Axelson and Ms. Chiappetta are with the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center; and Dr. Strober is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles.
D000293:Adolescent; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D003220:Conflict, Psychological; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology* / Q000523:psychology*; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data*; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires