title: Mood lability among offspring of parents with bipolar disorder and community controls.
abstract: OBJECTIVE
  Early identification of bipolar disorder (BP) symptomatology is crucial for improving the prognosis of this illness. Increased mood lability has been reported in BP. However, mood lability is ubiquitous across psychiatric disorders and may be a marker of severe psychopathology and not specific to BP. To clarify this issue, this study examined the prevalence of mood lability and its components in offspring of BP parents and offspring of community control parents recruited through the Pittsburgh Bipolar Offspring Study.
  
  
  METHODS
  Forty-one school-age BP offspring of 38 BP parents, 257 healthy or non-BP offspring of 174 BP parents, and 192 offspring of 117 control parents completed a scale that was developed to evaluate mood lability in youth, i.e., the Children's Affective Lability Scale (CALS).
  
  
  RESULTS
  A factor analysis of the parental CALS, and in part the child CALS, revealed Irritability, Mania, and Anxiety/Depression factors, with most of the variance explained by the Irritability factor. After adjusting for confounding factors (e.g., parental and offspring non-BP psychopathology), BP offspring of BP parents showed the highest parental and child total and factor scores, followed by the non-BP offspring of BP parents, and then the offspring of the controls.
  
  
  CONCLUSIONS
  Mood lability overall and mania-like, anxious/depressed, and particularly irritability symptoms may be a prodromal phenotype of BP among offspring of parents with BP. Prospective studies are warranted to clarify whether these symptoms will predict the development of BP and/or other psychopathology. If confirmed, these symptoms may become a target of treatment and biological studies before BP develops.
authors.affiliation: Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. birmaherb@upmc.edu
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: Benjamin I
authors.initials: BI
authors.lastname: Goldstein
authors.forename: David A
authors.initials: DA
authors.lastname: Axelson
authors.forename: Kelly
authors.initials: K
authors.lastname: Monk
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Hickey
authors.forename: Jieyu
authors.initials: J
authors.lastname: Fan
authors.forename: Satish
authors.initials: S
authors.lastname: Iyengar
authors.forename: Wonho
authors.initials: W
authors.lastname: Ha
authors.forename: Rasim S
authors.initials: RS
authors.lastname: Diler
authors.forename: Tina
authors.initials: T
authors.lastname: Goldstein
authors.forename: David
authors.initials: D
authors.lastname: Brent
authors.forename: Cecile D
authors.initials: CD
authors.lastname: Ladouceur
authors.forename: Dara
authors.initials: D
authors.lastname: Sakolsky
authors.forename: David J
authors.initials: DJ
authors.lastname: Kupfer
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D016009:Chi-Square Distribution; D016241:Child of Impaired Parents / Q000523:psychology*; D005260:Female; D006801:Humans; D007508:Irritable Mood / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics
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