High risk for psychiatric disorders in bipolar offspring. A four years prospective study

Eraso-Osorio, Juan Jose; Palacio-Ortíz, Juan David; Quintero-Cadavid, Claudia Patricia; Estrada-Jaramillo, Santiago; Andrade-Carrillo, Rommel; Gómez-Cano, Sujey; García-Valencia, Jenny; Aguirre–Acevedo, Daniel Camilo; Duque-Rios, Paula Andrea; Valencia-Echeverry, Johanna; López‐Jaramillo, Carlos

doi:10.1016/j.rcp.2020.01.008

Cited by 2 publications

(1 citation statement)

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“…We first generated pseudo-individual participant data (pseudo-IPD), whose survival curve would be identical to the pub lished survival curves, using an established methodology 44 as in previous meta-analyses 45,46 . For a study 47 which reported separate Kaplan-Meier plots for bipolar disorder and bipolar disorder not oth er wise specified in the same sample, we matched the events of each curve with censors occurring at the same age in the other curve, to generate a single dataset. Second, we combined the datasets from the different studies to estimate a curve for the risk of psychosis in the offspring of parents with psychosis, a curve for the risk of bipolar disorder in the offspring of parents with bipolar disorder, and a curve for the risk of depressive disorders in the offspring of parents with depressive disorders.…”

Section: Statistical Analysesmentioning

confidence: 99%

Transdiagnostic risk of mental disorders in offspring of affected parents: a meta‐analysis of family high‐risk and registry studies

Uher,

Pavlova,

Radua

et al. 2023

World Psychiatry

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The offspring of parents with mental disorders are at increased risk for developing mental disorders themselves. The risk to offspring may extend transdiagnostically to disorders other than those present in the parents. The literature on this topic is vast but mixed. To inform targeted prevention and genetic counseling, we performed a comprehensive, PRISMA 2020‐compliant meta‐analysis. We systematically searched the literature published up to September 2022 to retrieve original family high‐risk and registry studies reporting on the risk of mental disorders in offspring of parents with any type of mental disorder. We performed random‐effects meta‐analyses of the relative risk (risk ratio, RR) and absolute risk (lifetime, up to the age at assessment) of mental disorders, defined according to the ICD or DSM. Cumulative incidence by offspring age was determined using meta‐analytic Kaplan‐Meier curves. We measured heterogeneity with the I2 statistic, and risk of bias with the Quality In Prognosis Studies (QUIPS) tool. Sensitivity analyses addressed the impact of study design (family high‐risk vs. registry) and specific vs. transdiagnostic risks. Transdiagnosticity was appraised with the TRANSD criteria. We identified 211 independent studies that reported data on 3,172,115 offspring of parents with psychotic, bipolar, depressive, disruptive, attention‐deficit/hyperactivity, anxiety, substance use, eating, obsessive‐compulsive, and borderline personality disorders, and 20,428,575 control offspring. The RR and lifetime risk of developing any mental disorder were 3.0 and 55% in offspring of parents with anxiety disorders; 2.6 and 17% in offspring of those with psychosis; 2.1 and 55% in offspring of those with bipolar disorder; 1.9 and 51% in offspring of those with depressive disorders; and 1.5 and 38% in offspring of those with substance use disorders. The offspring's RR and lifetime risk of developing the same mental disorder diagnosed in their parent were 8.4 and 32% for attention‐deficit/hyperactivity disorder; 5.8 and 8% for psychosis; 5.1 and 5% for bipolar disorder; 2.8 and 9% for substance use disorders; 2.3 and 14% for depressive disorders; 2.3 and 1% for eating disorders; and 2.2 and 31% for anxiety disorders. There were 37 significant transdiagnostic associations between parental mental disorders and the RR of developing a different mental disorder in the offspring. In offspring of parents with psychosis, bipolar and depressive disorder, the risk of the same disorder onset emerged at 16, 5 and 6 years, and cumulated to 3%, 19% and 24% by age 18; and to 8%, 36% and 46% by age 28. Heterogeneity ranged from 0 to 0.98, and 96% of studies were at high risk of bias. Sensitivity analyses restricted to prospective family high‐risk studies confirmed the pattern of findings with similar RR, but with greater absolute risks compared to analyses of all study types. This study demonstrates at a global, meta‐analytic level that offspring of affected parents have strongly elevated RR and lifetime risk of developing any mental disorder as well as the same mental disorder diagnosed in the parent. The transdiagnostic risks suggest that offspring of parents with a range of mental disorders should be considered as candidates for targeted primary prevention.

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