Review of studies of child and adolescent offspring of bipolar parents

Abstract

Studies suggest that children (< or =21 years) of BP parents are at increased risk for developing mood and other disorders (e.g., disruptive, anxiety). Therefore, additional investigations are clearly warranted. In the context of current research on diagnosis, assessment, longitudinal course and comorbidity of childhood mania, the following suggestions for the design of future studies should be considered: 1) Phenotypic specification of bipolar manifestations (e.g., BP-I, BP-II, BP-NOS) in child/adolescent offspring and in bipolar parents themselves. 2) Control groups that are pediatric-age relevant and thus include attention-deficit hyperactivity disorder. 3) Assessments that include items for prepubertal mania and for onsets and offsets of all occurrences of symptoms and of environmental factors (e.g., life events) in offspring and in parents so that trajectories of overlap and sequence between child and parental mania can be investigated. 4) These detailed onsets and offsets of symptoms are also necessary to investigate prodromal manifestations of mania in the offspring. 5) Unaffected offspring present a unique opportunity to study pre- and postmorbid cognitive and physiological endophenotypes and structural and functional brain abnormalities. Findings from offspring studies will be crucial to inform research on the development of early intervention and prevention strategies.

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

“…In 1997, Lapalme et al (1) showed in a meta-analysis (N=2,973) that bipolar offspring have 2.7 times the risk of developing a mental disorder and 4 times the risk of developing a mood disorder compared with children of healthy parents. 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).…”

“…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).…”

Facial Emotion Labeling Deficits in Children and Adolescents at Risk for Bipolar Disorder

“…While most studies of children at risk for bipolar disorder have focused on clinical description (12), more recent work has also examined potential neurophysiological (13) and neuropsychological (14) deficits. Research should build on this work by assessing the processing of emotional stimuli in first-degree relatives of bipolar patients.…”

Evidence-Based Treatment

“…Reviews by DelBello and Geller [48] of 17 studies and by Jones and Bentall [49] of an additional 10 recent studies concluded that children of parents with bipolar disorder showed higher rates of psychopathology, mood disorders and bipolar disorder. Rates of mood disorder in children of bipolar adults ranged from 5-67% compared with 0-38% of normal controls.…”