Clinical, demographic, and familial correlates of bipolar spectrum disorders among offspring of parents with bipolar disorder.
OBJECTIVE
Despite increased risk, most offspring of parents with bipolar disorder (BP) do not manifest BP. The identification of risk factors for BP among offspring could improve preventive and treatment strategies. We examined this topic in the Pittsburgh Bipolar Offspring Study (BIOS).


METHODS
Subjects included 388 offspring, ages 7-17 years, of 233 parents with BP-I or BP-II (via the Structured Clinical Interview for DSM-IV). Offspring diagnoses were determined using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Present and Lifetime version (KSADS-PL). Analyses focused on the 41 offspring who were diagnosed with BP-I (N = 9), BP-II (N = 5), or BP-NOS (N = 27).


RESULTS
Offspring with BP had proband parents who were significantly younger at the time of their birth, were more likely to be female, and had lower socio-economic status, versus proband parents of offspring without BP. Parental clinical variables and obstetric variables were not significantly associated with BP among offspring. History of physical and/or sexual abuse, exposure to antidepressants, and exposure to stimulants was significantly greater among offspring with versus without BP. There was significantly greater prevalence of attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, oppositional defiant disorder/conduct disorder (ODD/CD), and exposure to stimulants and antidepressants among offspring with versus without BP. Variables significantly associated with BP among offspring in regression analyses were as follows: older offspring age, younger parent age at birth, offspring anxiety disorders and ODD/CD, and biological coparent with BP.


CONCLUSIONS
History of anxiety and/or disruptive behavior disorders, as well as presence of bi-lineal parental BP, is associated with elevated risk of bipolar spectrum disorders among offspring. If replicated prospectively, these findings could have implications for the diagnosis and treatment of psychopathology among BP offspring.
Goldstein
Benjamin I
BI
Faculty of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N-3M5, Canada.
Shamseddeen
Wael
W
Axelson
David A
DA
Kalas
Cathy
C
Monk
Kelly
K
Brent
David A
DA
Kupfer
David J
DJ
Birmaher
Boris
B
D000293:Adolescent; D000296:Adolescent Psychiatry; D000328:Adult; D000367:Age Factors; D000928:Antidepressive Agents; D001008:Anxiety Disorders / Q000150:complications / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications / Q000453:epidemiology; D001714:Bipolar Disorder / Q000150:complications / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D000697:Central Nervous System Stimulants; D002648:Child; D002649:Child Abuse; D002665:Child Psychiatry; D016241:Child of Impaired Parents / Q000523:psychology*; D019955:Conduct Disorder / Q000150:complications / Q000453:epidemiology; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D009774:Obstetrics; D010290:Parents / Q000523:psychology*; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors
D000928:Antidepressive Agents; D000697:Central Nervous System Stimulants
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