title: A developmental approach to dimensional expression of psychopathology in child and adolescent offspring of parents with bipolar disorder.
abstract: The aim of this is to describe psychopathology, functioning and symptom dimensions accounting for subthreshold manifestations and developmental status in child and adolescent offspring of parents with bipolar disorder ("high-risk offspring"). The study population comprised 90 high-risk offspring (HR-offspring) and 107 offspring of community control parents (CC-offspring). Direct clinical observations and parental and offspring reports based on selected standardized clinical scales were used to assess offspring threshold and subthreshold diagnoses, symptoms and functioning. All outcomes were compared between the whole HR-offspring and CC-offspring samples and then by developmental status. After controlling for potential confounders, HR-offspring showed significantly poorer adjustment for childhood (r = 0.18, p = 0.014) and adolescence (r = 0.21, p = 0.048) than CC-offspring, as well as more emotional problems (r = 0.24, p = 0.001) and higher depression scores (r = 0.16, p = 0.021). As for differences in lifetime categorical diagnoses (threshold and subthreshold) between HR-offspring and CC-offspring, the prevalence of disruptive disorders was higher in pre-pubertal HR-offspring (OR 12.78 [1.45-112.42]), while prevalence of mood disorders was higher in post-pubertal HR-offspring (OR 3.39 [1.14-10.06]). Post-pubertal HR-offspring presented more prodromal (r = 0.40, p = 0.001), negative (r = 0.38, p = 0.002), manic (r = 0.22, p = 0.035) and depressive (r = 0.23, p = 0.015) symptoms than pre-pubertal HR-offspring, as well as more peer relationship problems (r = 0.31, p = 0.004), poorer childhood adjustment (r = 0.22, p = 0.044) and worse current psychosocial functioning (r = 0.27, p = 0.04). Externalizing psychopathology is more prevalent in pre-pubertal HR-offspring, while depressive and prodromal symptoms leading to functional impairment are more prominent in post-pubertal HR-offspring. Developmental approaches and dimensional measures may be useful for identifying children at high risk of developing bipolar disorder and help guide specific preventive strategies.
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza 43, 28009, Madrid, Spain. goretti.moron@iisgm.com.|Department of Psychiatry and Clinical Psychology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain. goretti.moron@iisgm.com.
authors.forename: María Goretti
authors.identifier: http://orcid.org/0000-0001-7870-054X
authors.initials: MG
authors.lastname: Morón-Nozaleda
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza 43, 28009, Madrid, Spain.
authors.forename: Covadonga M
authors.initials: CM
authors.lastname: Díaz-Caneja
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza 43, 28009, Madrid, Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: Rodríguez-Toscano
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza 43, 28009, Madrid, Spain.
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.|Institut d'Investigacións Biomèdiques d'August Pi i Sunyer, IDIBAPS, Barcelona, Spain.|Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain.|Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain.
authors.forename: Josefina
authors.initials: J
authors.lastname: Castro-Fornieles
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.|Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: de la Serna
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza 43, 28009, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Espliego
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.|Early Psychosis Program and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Tarragona, Spain.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Sanchez-Gistau
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.|Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain.
authors.forename: Soledad
authors.initials: S
authors.lastname: Romero
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.|Institut d'Investigacións Biomèdiques d'August Pi i Sunyer, IDIBAPS, Barcelona, Spain.|Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain.
authors.forename: Immaculada
authors.initials: I
authors.lastname: Baeza
authors.affiliation: Institut d'Investigacións Biomèdiques d'August Pi i Sunyer, IDIBAPS, Barcelona, Spain.|Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain.
authors.forename: Gisela
authors.initials: G
authors.lastname: Sugranyes
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza 43, 28009, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Moreno
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza 43, 28009, Madrid, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Moreno
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000523:psychology*; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D002658:Developmental Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D015995:Prevalence; D011599:Psychopathology / Q000379:methods*
keywords: Bipolar disorder; Developmental psychopathology; High risk