title: Childhood-onset bipolar disorder: Evidence for increased familial loading of psychiatric illness.
abstract: OBJECTIVE
  To determine whether childhood-onset bipolar disorder (BP) is associated with an increased psychiatric family history compared with adolescent-onset BP.
  
  
  METHODS
  Semistructured psychiatric interviews were conducted for 438 youth with BP spectrum disorders. To evaluate the effects of age at onset and psychiatric family history, the sample was divided into childhood-onset BP (age and BP onset <12 years; n = 192), adolescents with early-onset BP (age > or =12 years and BP onset <12 years; n = 136), and adolescents with late-onset BP (age and BP onset > or =12 years; n = 110). Lifetime family history of psychiatric illness was ascertained for first- and second-degree relatives through both direct interview of caretakers and the Family History Screen.
  
  
  RESULTS
  After significant demographic and clinical factors were controlled for, children and adolescents with childhood-onset BP showed higher percentages of positive first-degree family history for depression, anxiety, attention-deficit/hyperactivity, conduct, and substance dependence disorders and suicidal behaviors compared with adolescents with late onset. Subjects with childhood-onset BP also showed elevated familial loading for depression and attention-deficit/hyperactive disorder in second-degree relatives.
  
  
  CONCLUSIONS
  These data support a model that postulates a higher density of familial risk for a broad range of psychopathology in childhood-onset BP.
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA. Richard_Rende@Brown.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Rende
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: David
authors.initials: D
authors.lastname: Axelson
authors.forename: Michael
authors.initials: M
authors.lastname: Strober
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Gill
authors.forename: Sylvia
authors.initials: S
authors.lastname: Valeri
authors.forename: Laurel
authors.initials: L
authors.lastname: Chiappetta
authors.forename: Neal
authors.initials: N
authors.lastname: Ryan
authors.forename: Henrietta
authors.initials: H
authors.lastname: Leonard
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hunt
authors.forename: Satish
authors.initials: S
authors.lastname: Iyengar
authors.forename: Martin
authors.initials: M
authors.lastname: Keller
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001714:Bipolar Disorder / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D002648:Child; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D005820:Genetic Testing; D005838:Genotype; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D010641:Phenotype