title: Can pediatric bipolar-I disorder be diagnosed in the context of posttraumatic stress disorder? A familial risk analysis.
abstract: Despite ongoing concerns that traumatized children with severe symptoms of emotional dysregulation may be inappropriately receiving a diagnosis of pediatric bipolar-I (BP-I) disorder, this issue has not been adequately examined in the literature. Because both pediatric BP-I disorder and posttraumatic stress disorder (PTSD) are familial disorders, if children with both BP-I and PTSD were to be truly affected with BP-I disorder, their relatives would be at high risk for BP-I disorder. To this end, we compared patterns of familial aggregation of BP-I disorder in BP-I children with and without PTSD with age and sex matched controls. Participants were 236 youths with BP-I disorder and 136 controls of both sexes along with their siblings. Participants completed a large battery of measures designed to assess psychiatric disorders, psychosocial, educational, and cognitive parameters. Familial risk analysis revealed that relatives of BP-I probands with and without PTSD had similar elevated rates of BP-I disorder that significantly differed from those of relatives of controls. Pediatric BP-I disorder is similarly highly familial in probands with and without PTSD indicating that their co-occurrence is not due to diagnostic error.
authors.affiliation: Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA 02114-3139, USA. jbiederman@partners.org
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Janet
authors.initials: J
authors.lastname: Wozniak
authors.forename: Mary Kate
authors.initials: MK
authors.lastname: Martelon
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Spencer
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Woodworth
authors.forename: Gagan
authors.initials: G
authors.lastname: Joshi
authors.forename: Andrea
authors.initials: A
authors.lastname: Spencer
authors.forename: Mai
authors.initials: M
authors.lastname: Uchida
authors.forename: Amelia
authors.initials: A
authors.lastname: Kotte
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000453:epidemiology
keywords: Clinical correlates; Comorbidity; Family risk analysis