| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Axelson, David Goldstein, Benjamin Goldstein, Tina Monk, Kelly Yu, Haifeng Hickey, Mary Beth Sakolsky, Dara Diler, Rasim Hafeman, Danella Merranko, John Iyengar, Satish Brent, David Kupfer, David Birmaher, Boris |
| Spatial Coverage |
Pennsylvania |
| Description |
Author Affiliation: Axelson D ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Goldstein B ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Goldstein T ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Monk K ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Yu H ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Hickey MB ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Sakolsky D ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Diler R ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Hafeman D ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Merranko J ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Iyengar S ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Brent D ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Kupfer D ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus); Birmaher B ( From the Department of Psychiatry, Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus) |
| Abstract |
OBJECTIVE: The authors sought to identify diagnostic risk factors of manic, mixed, or hypomanic episodes in the offspring of parents with bipolar disorder ('high-risk offspring'). METHOD: High-risk offspring 6-18 years old (N=391) and demographically matched offspring (N=248) of community parents without bipolar disorder were assessed longitudinally with standardized diagnostic instruments by staff blind to parental diagnoses. Follow-up assessments were completed in 91% of the offspring (mean follow-up interval, 2.5 years; mean follow-up duration, 6.8 years). RESULTS: Compared with community offspring, high-risk offspring had significantly higher rates of subthreshold mania or hypomania (13.3% compared with 1.2%), manic, mixed, or hypomanic episodes (9.2% compared with 0.8%), and major depressive episodes (32.0% compared with 14.9%). They also had higher rates of attention deficit hyperactivity disorder (30.7% compared with 18.1%), disruptive behavior disorders (27.4% compared with 15.3%), anxiety disorders (39.9% compared with 21.8%), and substance use disorders (19.9% compared with 10.1%), but not unipolar major depressive disorder (major depression with no bipolarity; 18.9% compared with 13.7%). Multivariate Cox regressions showed that in the high-risk offspring, subthreshold manic or hypomanic episodes (hazard ratio=2.29), major depressive episodes (hazard ratio=1.99), and disruptive behavior disorders (hazard ratio=2.12) were associated with subsequent manic, mixed, or hypomanic episodes. Only subthreshold manic or hypomanic episodes (hazard ratio=7.57) were associated when analyses were restricted to prospective data. CONCLUSIONS: Subthreshold manic or hypomanic episodes were a diagnostic risk factor for the development of manic, mixed, or hypomanic episodes in the offspring of parents with bipolar disorder and should be a target for clinical assessment and treatment research. Major depressive episodes and disruptive behavior disorders are also indications for close clinical monitoring of emergent bipolarity in high-risk offspring. |
| File Format |
HTM / HTML |
| ISSN |
0002953X |
| e-ISSN |
15357228 |
| DOI |
10.1176/appi.ajp.2014.14010035 |
| Journal |
American Journal of Psychiatry |
| Issue Number |
7 |
| Volume Number |
172 |
| Language |
English |
| Publisher |
American Psychiatric Association |
| Publisher Date |
2015-07-01 |
| Publisher Place |
United States |
| Access Restriction |
Open |
| Subject Keyword |
Discipline Psychiatry Bipolar Disorder Diagnosis Genetics Child Of Impaired Parents Psychology Adolescent Comorbidity Cross-sectional Studies Depressive Disorder, Major Longitudinal Studies Mental Disorders Pennsylvania Psychiatric Status Rating Scales Risk Factors |
| Content Type |
Text |
| Resource Type |
Article |
| Subject |
Psychiatry and Mental Health |
