Psychiatric Disorders in Preschool Offspring of Parents With Bipolar Disorder: The Pittsburgh Bipolar Offspring Study (BIOS)

Abstract

Objective-To evaluate lifetime prevalence and specificity of DSM-IV psychiatric disorders and severity of depressive and manic symptoms at intake in preschool offspring of parents with Disorder I-II.Methods-121 offspring ages 2-5 years old of 83 parents with Bipolar Disorder and 102 offspring of 65 demographically matched control parents (29 with non-Bipolar psychiatric disorders and 36 without any lifetime psychopathology) were recruited. Parents with Bipolar Disorder were recruited through advertisement and adult outpatient clinics and control parents were ascertained at random from the community. Subjects were evaluated with standardized instruments. All staff were blind to parental diagnoses.Results-After adjusting for within-family correlations and both biological parents' non-Bipolar psychopathology, compared to the offspring of the control parents, offspring of parents with Bipolar Disorder, particularly those older than 4 years old, showed an 8-fold increased life-time prevalence of Attention Deficit Hyperactive Disorder (ADHD) and significantly higher rates of ≥ 2 psychiatric disorders. While only 3 offspring of parents with Bipolar Disorder had mood disorders, offspring of parents with Bipolar Disorder, especially those with ADHD and Oppositional-Defiant Disorder, had significantly more severe current manic and depressive symptomatology than the offspring of the controls.Conclusions-Preschool offspring of parents with Bipolar Disorder are at increased risk for ADHD and demonstrate increased subthreshold manic and depressive symptomatology. Longitudinal follow-up is warranted to evaluate whether these children are at high-risk to develop mood and other psychiatric disorders.

The Dutch Bipolar Offspring Study: 12-Year Follow-Up

“…More recently, two review articles on bipolar offspring reported elevated but varying prevalence rates of bipolar disorder (ranging from 3% to 27%), mood disorders (ranging from 5% to 67%), and non-mood disorders (ranging from 5% to 52%) (2,3). However, these studies could not fully address the development and early course of bipolar disorder and other mood disorders because they used either a crosssectional design or a longitudinal design without follow-up into adulthood (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). We report here on one of the largest prospective bipolar offspring studies with a follow-up into adulthood: the 12-year follow-up of the Dutch bipolar offspring cohort (7,10,12).…”

Estudio comparativo de psicopatología en hijos de padres con trastorno bipolar

“…Este hallazgo es interesante debido a que, a pesar de que la muestra total de niños y adolescentes fue obtenida de la comunidad, en el presente estudio la frecuencia de trastornos externalizados en hijos de padres con TBP fue casi 15 veces más alta que la reportada en otros estudios con población general 23 y casi 50 veces más alta que la reportada en la encuesta nacional de adolescentes. 24 Los resultados también son consistentes con otros estudios internacionales que reportan tasas elevadas de trastornos de conducta disruptiva y TDAH en los hijos de padres con TBP cuando se comparan con hijos de padres sanos 19 y/o con otra psicopatología diferente al TBP.…”

“…10 Cuando consideramos la perspectiva del desarrollo, los estudios realizados en preescolares reportan una prevalencia ocho veces mayor para la presencia de TDAH, así como mayor frecuencia de síntomas depresivos y maniacos subumbrales, en comparación con los hijos de padres sin TBP. 19 En la adolescencia se observa un incremento en la prevalencia del diagnóstico de TBP (de 3 a 10%) y en mayor proporción para cualquier trastorno del ánimo (40%). 20 El estudio de esta población es interesante debido a las necesidades de atención, disfunción y psicopatología temprana que influyen, en una trayectoria heterotípica, en otros trastornos crónicos y discapacitantes.…”

Challenges and developments in research of the early stages of bipolar disorder

“…47 There are often differences in the sampling or recruitment strategy employed (clinical/community; offspring of one affected parent/two affected parents), the assessments used (self/observer-rated), and the timeframe of assessment (cross-sectional/longitudinal; retrospective/prospective). The methods employed to recruit families into OSBP studies also vary widely, and include recruitment of families already involved in neurobiological and genetic research projects, 48 recruitment of all or some participants via selfreferral and/or advertising campaigns, 49 recruitment from hospital settings and specialized clinics, 50 and from patient advocacy associations. 44 Notably, higher rates of comorbidity are evident in studies that recruit via selfreferral and families where the non-proband parent also had a non-affective psychiatric illness.…”