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. 2009 Mar;66(3):287-96.
doi: 10.1001/archgenpsychiatry.2008.546.

Lifetime psychiatric disorders in school-aged offspring of parents with bipolar disorder: the Pittsburgh Bipolar Offspring study

Boris Birmaher  1 , David Axelson, Kelly Monk, Catherine Kalas, Benjamin Goldstein, Mary Beth Hickey, Mihaela Obreja, Mary Ehmann, Satish Iyengar, Wael Shamseddeen, David Kupfer, David Brent
Affiliations

Lifetime psychiatric disorders in school-aged offspring of parents with bipolar disorder: the Pittsburgh Bipolar Offspring study

Boris Birmaher et al. Arch Gen Psychiatry. 2009 Mar.

Abstract

Context: Whether offspring of parents with bipolar disorder (BP) are at specifically high risk to develop BP and other psychiatric disorders has not been adequately studied.

Objective: To evaluate lifetime prevalence and specificity of psychiatric disorders in offspring of parents with BP-I and BP-II.

Design: Offspring aged 6 to 18 years who have parents with BP and community control subjects were interviewed with standardized instruments. All research staff except the statistician were blind to parental diagnoses.

Setting: Parents with BP were recruited primarily through advertisement and outpatient clinics. Control parents were ascertained by random-digit dialing and were group matched for age, sex, and neighborhood to parents with BP.

Participants: Three hundred eighty-eight offspring of 233 parents with BP and 251 offspring of 143 demographically matched control parents.

Main outcome measures: Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) Axis I disorders.

Results: Adjusting for demographic factors, living with 1 vs both biological parents, both biological parents' non-BP psychopathology, and within-family correlations, offspring of parents with BP showed high risk for BP spectrum disorders (odds ratio [OR] = 13.4; 95% confidence interval [CI], 2.9-61.6) and any mood (OR = 5.2; 95% CI, 2.3-11.4), anxiety (OR = 2.3; 95% CI, 1.3-4.0), and Axis I (OR = 2.2; 95% CI, 1.5-3.3) disorders. Offspring of parents with BP with high socioeconomic status showed more disruptive behavior disorders and any Axis I disorders than offspring of control parents with high socioeconomic status. Families in which both parents had BP had more offspring with BP than families with only 1 parent with BP (OR = 3.6; 95% CI, 1.1-12.2). More than 75.0% of offspring who developed BP had their first mood episode before age 12 years, with most of these episodes meeting criteria for BP not otherwise specified and, to a lesser degree, major depression.

Conclusions: Offspring of parents with BP are at high risk for psychiatric disorders and specifically for early-onset BP spectrum disorders. These findings further support the familiality and validity of BP in youth and indicate a need for early identification and treatment.

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Figures

Figure 1
Figure 1
Recruitment of parents with bipolar disorder (BP) and community control parents (probands). UCSUR indicates University Center for Social and Urban Research.
Figure 2
Figure 2
Cumulative rates by age at onset of any mood episodes (A), bipolar disorder (BP) episodes (mania, hypomania, mixed, or operationalized BP not-otherwise-specified episodes) (B), and depressive episodes (major depressive episodes excluding youth with BP) (C).
See this image and copyright information in PMC

Comment in

  • Bipolar disorder?
    Mattes JA. Mattes JA. Arch Gen Psychiatry. 2010 Nov;67(11):1198. doi: 10.1001/archgenpsychiatry.2010.143. Arch Gen Psychiatry. 2010. PMID: 21041621 No abstract available.

References

    1. Goodwin FK, Jamison K. Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression. 2nd ed. Oxford University Press; New York, NY: 2007.
    1. Leboyer M, Henry C, Paillere-Martinot M-L, Bellivier F. Age at onset in bipolar affective disorders: a review. Bipolar Disord. 2005;7(2):111–118. - PubMed
    1. Pavuluri MN, Birmaher B, Naylor MW. Pediatric bipolar disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 2005;44(9):846–871. - PubMed
    1. Birmaher B, Axelson D, Pavaluri M. Bipolar disorder. In: Martin A, Volkmar FR, Lewis M, editors. Lewis's Child and Adolescent Psychiatry: A Comprehensive Textbook. 4th ed. Lippincott Williams & Wilkins; London, England: 2007.
    1. Lapalme M, Hodgins S, LaRoche C. Children of parents with bipolar disorder: a metaanalysis of risk for mental disorders. Can J Psychiatry. 1997;42(6):623–631. - PubMed

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