A Longitudinal Study of Psychiatric Disorders in Offspring of Parents With Bipolar Disorder From Preschool to Adolescence - 26/10/21
, John Merranko, MA a, Danella Hafeman, MD a, Benjamin I. Goldstein, MDPhD a, b, Rasim Diler, MD a, Jessica C. Levenson, PhD a, Kelly Monk, BSNRN a, Satish Iyengar, PhD c, Mary Beth Hickey, BA a, Dara Sakolsky, MD a, David Axelson, MD d, Tina Goldstein, PhD aRésumé |
Objective |
To compare the prevalence of psychopathology, particularly bipolar disorder (BD), between preschool offspring of parents with BD and community controls.
Method |
A total of 116 offspring of BD-I/II parents and 98 controls (53 parents with non-BD psychopathology and 45 healthy parents) were recruited at ages 2 to 5 years and followed on average 9.6 years (on average: 2−5: 1.6 times; after age 5: 4 times) (average ages at intake/last follow-up: 3.8/13.4, retention: 98%). Participants were evaluated with standardized instruments blinded to parental diagnoses.
Results |
After adjusting for confounders, offspring of BD parents only showed more attention-deficit/hyperactivity disorder (ADHD) during ages 2 to 5 years than the other 2 groups. After age 5, offspring of BD parents did not differ from offspring of parents with non-BD psychopathology, but they had more anxiety, ADHD, and behavior problems than offspring of healthy parents. Only offspring of BD parents developed BD-I/II: 3.4% (n = 4) and BD−not-otherwise-specified (BD-NOS): 11.2% (n = 13), with mean onset ages 11.4 and 7.4, respectively. About 70% of offspring with BD had non-BD disorders before BD. Only ADHD, diagnosed before age 6 years, and early-onset parental BD were significantly associated with BD risk.
Conclusion |
Most offspring of BD parents did not develop BD, but they were at specific high risk for developing BD, particularly those with preschool ADHD and early-onset parental BD. BD symptoms were scarce during the preschool years and increased throughout the school age, mainly in the form of BD-NOS, a disorder that conveys poor prognosis and high risk to develop BD-I/II. Developing early interventions to delay or, ideally, to prevent its onset are warranted.
Le texte complet de cet article est disponible en PDF.Key words : bipolar disorder, preschoolers, offspring, psychopathology, high-risk
Plan
| This paper was supported by National Institute of Mental Health (NIMH) grant RO1 MH060952. The work was completed at Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine. This manuscript represents original material that has never been published before, is not under consideration for publication elsewhere, and has been approved by each author. |
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| Dr. Merranko served as the statistical expert for this research. |
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| Author Contributions Conceptualization: Birmaher, B. Goldstein, Diler, Monk, Iyengar, Axelson, T. Goldstein Data curation: Birmaher, Merranko, Monk, Hickey, Axelson Formal analysis: Birmaher, Merranko, Hafeman, B. Goldstein, Diler, Levenson, Iyengar, Axelson, T. Goldstein Funding acquisition: Birmaher, Monk, Axelson Investigation: Birmaher, Merranko, Hafeman, B. Goldstein, Diler, Monk, Sakolsky, Axelson, T. Goldstein Methodology: Birmaher, Monk, Iyengar, Hickey, Axelson, T. Goldstein Project administration: Birmaher, Monk, Axelson Resources: Birmaher, Monk, Axelson Software: Merranko, Hickey Supervision: Birmaher, Hafeman, Monk, Sakolsky, Axelson, T. Goldstein Validation: Birmaher, Merranko, Hafeman, B. Goldstein, Diler, Monk, Sakolsky, Axelson, T. Goldstein Visualization: Birmaher, Merranko, Hafeman, B. Goldstein, Diler, Monk, Sakolsky, Axelson, T. Goldstein Writing – original draft: Birmaher, Axelson Writing – review and editing: Birmaher, Merranko, Hafeman, B. Goldstein, Diler, Levenson, Monk, Iyengar, Hickey, Sakolsky, Axelson, T. Goldstein |
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| The authors would like to thank the studies’ participants and their families, the research assistants, and Rita Scholle, BA, of the University of Pittsburgh Medical Center, for preparation of the manuscript. The authors would also like to acknowledge Stacia Friedman-Hill, PhD, of NIMH, for her continued encouragement and support. |
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| Disclosure: Dr. Birmaher has received grants from NIMH, during the conduct of the study, and royalties from Random House, UpToDate, and Lippincott, Williams, and Wilkins, outside of the submitted work. Dr. Hafeman has received grants from NIMH and the Brain and Behavior Research Foundation. Dr. B. Goldstein has received grant funding from Brain Canada, the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Canada, NIMH, and the departments of psychiatry of Sunnybrook Health Sciences Centre and the University of Toronto. Dr. Diler has received research support from NIMH. Dr. Levenson has received grant support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute on Drug Abuse, and the University of Pittsburgh and royalties from American Psychological Association Books. Dr. Sakolsky has received grant support from NIMH. Dr. Axelson has received grants from NIMH, during the conduct of the study, and royalties from Wolters-Kluwer / UpToDate, outside the submitted work. Dr. T. Goldstein has received grants from NIMH, the American Foundation for Suicide Prevention, the University of Pittsburgh Clinical and Translational Science Institute (CTSI), and the Brain and Behavior Foundation and royalties from Guilford Press, outside the submitted work. Dr. Iyengar, Mr. Merranko, and Mss. Monk and Hickey have reported no biomedical financial interests or potential conflicts of interest. |
Vol 60 - N° 11
P. 1419-1429 - novembre 2021 Retour au numéro
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