title: Child comorbidity, maternal mood disorder, and perceptions of family functioning among bipolar youth.
abstract: 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.
authors.affiliation: 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.
authors.forename: Christianne
authors.initials: C
authors.lastname: Esposito-Smythers
authors.affiliation: 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.
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.affiliation: 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.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Valeri
authors.affiliation: 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.
authors.forename: Laurel
authors.initials: L
authors.lastname: Chiappetta
authors.affiliation: 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.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hunt
authors.affiliation: 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.
authors.forename: Neal
authors.initials: N
authors.lastname: Ryan
authors.affiliation: 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.
authors.forename: David
authors.initials: D
authors.lastname: Axelson
authors.affiliation: 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.
authors.forename: Michael
authors.initials: M
authors.lastname: Strober
authors.affiliation: 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.
authors.forename: Henrietta
authors.initials: H
authors.lastname: Leonard
authors.affiliation: 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.
authors.forename: Holly
authors.initials: H
authors.lastname: Sindelar
authors.affiliation: 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.
authors.forename: Martin
authors.initials: M
authors.lastname: Keller
mesh_terms: 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