title: Association of bipolar and substance use disorders in parents of adolescents with bipolar disorder.
abstract: BACKGROUND
  We have previously shown that juvenile bipolar disorder (BPD) is a risk for substance use disorders (SUD). Here we examine the expression of both disorders in families of youth with BPD to evaluate the familial risk mechanism.
  
  
  METHODS
  We studied 108 adolescent BPD probands with 187 parents (34 with SUD and 58 parents) and 96 control probands with 177 parents with structured interviews. We compared the prevalence of BPD and SUD with Cox proportional hazards models with time to onset of BPD or SUD as the dependent variable and proband diagnosis (Control, BPD, or BPD+SUD) as the independent variable.
  
  
  RESULTS
  The parents of the proband youth with BPD (without SUD) and BPD+SUD were more likely to develop BPD than the parents of control subjects [omnibus test chi2=10.18, p=.006]; we found no differences between the two bipolar groups. Parents of proband youth with BPD and with BPD+SUD were more likely than relatives of control subjects to develop SUD [omnibus test chi2=14.69, p<.001]; however, we found no differences between the parents of the two proband bipolar groups. Within the parents of proband youth with BPD+SUD, we found higher risk of SUD in parents with BPD than in those without BPD [chi2=8.39, p=.004], although the frequency of BPD was low in this group of parents.
  
  
  CONCLUSIONS
  Bipolar disorder and SUD are prevalent in the first-degree relatives of adolescents with BPD. Adults with BPD were more likely to manifest SUD with preliminary evidence of BPD and SUD cosegregation.
authors.affiliation: Pediatric Psychopharmacology Unit, Massachusetts General Hospital, and Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02114, USA. twilens@partners.org
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Wilens
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Joel
authors.initials: J
authors.lastname: Adamson
authors.forename: Michael
authors.initials: M
authors.lastname: Monuteaux
authors.forename: Aude
authors.initials: A
authors.lastname: Henin
authors.forename: Stephanie
authors.initials: S
authors.lastname: Sgambati
authors.forename: Alison
authors.initials: A
authors.lastname: Santry
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D039721:Diagnostic and Statistical Manual of Mental Disorders; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D015995:Prevalence; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D000297:Psychology, Adolescent; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology*