Children with a parental history of bipolar disorder (BD) are at increased for DSM-IV axis I disorders, research shows.
The risk was significantly elevated among children with a parental history of bipolar disorder with psychotic symptoms or bipolar II disorder (BD II), report Margarita Garcia-Amador (Hospital General Universitario Gregorio Marañón, Madrid, Spain) and team.
"Clinicians should routinely assess possible psychopathology in offspring, especially if the parental illness is characterized by psychotic symptoms or BD II," they advise in European Psychiatry.
The team studied 50 children, aged 6-17 years, who had at least one parent with BD, and 25 children without a parental history of mental health disorders. There were no significant differences between the groups regarding mean age, gender distribution, home intactness, or repetition of a school year.
All of the participants were assessed for DSM-IV axis I disorders using the Kiddie Schedule for Affective Disorders and Schizophrenia, present and lifetime version (K-SADS-PL).
In total, 25 (50%) children with a parental history of BD met criteria for at least one axis I disorder, of whom six met criteria for two and three met criteria for three axis I disorders. By contrast, just two children without such a parental history met criteria for one axis I disorder.
Among the children with a parental history of bipolar disorder who met criteria for axis I disorders, the most common conditions were attention-deficit/hyperactivity disorder (30%), anxiety disorders (14%), and affective disorders (10%).
After adjustment for sibling numbers, the team found that a parental history of BD with psychotic symptoms and parental history of BD II were associated with a significantly increased risk for axis I disorders, at odds ratios of 15.02 and 3.34, respectively.
The team also found that lower parental Global Assessment of Functioning scores were associated with a greater risk for axis I disorders in children with a parental history of BD.
Garcia-Amador et al conclude: "Early detection of psychopathology in children or adolescents, early intervention with children and improving functionality in biological co-parent[s] might lead to a better prognosis based on a better treatment of psychiatric symptoms, prevention of comorbid disorders, and the implementation of strategies for better psychosocial development."
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