High
risk for psychopathology in the offspring of
parents with bipolar disorder
Bipolar
disorder is a very debilitating psychiatric
disorder and, since it is highly familial,
offspring of parents suffering from this disease
represents an interesting group for studying
risk factors. A study has assessed the risk of
psychopathology in offspring of parents with or
without bipolar disorder. To examine the
influence of developmental level on this risk,
the sample was divided into early childhood,
middle childhood, and adolescence.
Participants were 117 non-referred offspring of
parents with bipolar disorder and 171 offspring
of parents without bipolar disorder or major
depression. DSM-IV–based Kiddie Schedule
for Affective Disorders and Schizophrenia
(K-SADS) and the Structured Clinical Interview
for DSM-IV (SCID) were used to assess childhood
diagnoses. Psychosocial functioning was
evaluated using Global Assessment of Functioning
(GAF) scores.
Offspring of bipolar parents had higher risks of
depression, mania,
attention-deficit/hyperactivity disorder (ADHD),
oppositional defiant disorder (ODD), separation
anxiety disorder, generalized anxiety disorder
(GAD), and obsessive-compulsive disorder (OCD)
than offspring of parents without mood
disorders, with a trend for social phobia and
panic/agoraphobia. Separation anxiety, social
phobia, ADHD, and ODD were likely to onset in
early childhood (< age 8). Nearly half of the
offspring had onset of depression in early
childhood and bipolar I disorder was most likely
to onset in adolescence. Bipolar offspring had
higher rates of placement in special classes,
more impaired GAF scores, and were more likely
to have received counseling, medication, and
been hospitalized.
These results showed that offspring of parents
with bipolar disorder are at high risk for many
severe psychiatric disorders and high levels of
psychosocial and educational dysfunction. They
also underscore the importance of considering
the developmental level of these offspring for
the risk for psychopathology. They suggest that
early, highly comorbid mood, disruptive
behavior, and anxiety disorders may be important
and useful markers of risk for subsequent
bipolar disorder in these youths. Henin
A, Biederman J, Mick E, Sachs GS,
Hirshfeld-Becker DR, Siegel RS, McMurrich S,
Grandin L, Nierenberg AA. Psychopathology in the
offspring of parents with bipolar disorder: a
controlled study. Biol Psychiatry 2005,
58:554-561.