title: Psychiatric disorders in child and adolescent offspring of patients with schizophrenia and bipolar disorder: A controlled study.
abstract: BACKGROUND
  Early clinical manifestations predating schizophrenia (SZ) and bipolar disorder (BP) have not been fully characterized. Child offspring studies are a valuable opportunity to study the natural history of the illness from its earliest stages. However, there is limited evidence assessing young offspring of SZ and BP simultaneously. We set out to assess rates of psychiatric disorders in child and adolescent offspring of SZ and BP, relative to offspring of community controls, so as to characterize the early phenotype of the disorders comparatively.
  
  
  METHODS
  SZ and BP parents with offspring aged 7-17years were recruited through adult mental health services of two tertiary hospitals. Community control (CC) parents were recruited from the same geographical area. Ninety BP-offspring, 41 SZ-offspring and 107 CC-offspring were assessed using the K-SADS-PL by child psychiatrists blinded to parental status. Differences in prevalence of psychiatric disorders between groups were adjusted for confounders and for sibling correlation using generalised estimating equations.
  
  
  RESULTS
  We found a gradient of clinical severity and social disadvantage between SZ, BP and CC-offspring. After adjusting for socio-demographic confounders, SZ and BP-offspring presented higher rates of attention deficit hyperactivity disorder (ADHD) than CC-offspring. ADHD was more prevalent in SZ-offspring than BP-offspring, and BP-offspring presented a higher prevalence of depression than CC-offspring.
  
  
  CONCLUSIONS
  The higher rates of ADHD in SZ-offspring suggest that abnormal neurodevelopmental processes may exert a stronger influence in SZ than BP. Follow-up of these children will help elucidate the role of ADHD and depression phenotypes in predicting future transition to SZ or BP.
authors.affiliation: Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain. Electronic address: vgistau@clinic.cat.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Sanchez-Gistau
authors.affiliation: Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain.
authors.forename: Soledad
authors.initials: S
authors.lastname: Romero
authors.affiliation: Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Moreno
authors.affiliation: Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: de la Serna
authors.affiliation: Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Baeza
authors.affiliation: Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
authors.forename: Gisela
authors.initials: G
authors.lastname: Sugranyes
authors.affiliation: Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Moreno
authors.affiliation: Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Sanchez-Gutierrez
authors.affiliation: Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: Rodriguez-Toscano
authors.affiliation: Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
authors.forename: Josefina
authors.initials: J
authors.lastname: Castro-Fornieles
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology*; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012559:Schizophrenia / Q000453:epidemiology*; D012720:Severity of Illness Index; D035781:Siblings
keywords: Bipolar disorder; Offspring; Psychopathology; Schizophrenia