At-risk individuals show possible treatment targets for bipolar disorder

By Lucy Piper, Senior medwireNews Reporter

Depressive, anxiety and behavioural disorders may be important preceding clinical features in the onset of bipolar disorder, with the potential for targeted preventive care of at-risk individuals, study findings suggest.

Analysis of semistructured interviews with participants aged 12 to 30 years showed that these disorders were more common among 118 individuals at high genetic risk for developing bipolar disorder than 110 individuals with no family risk.

The risk was increased a significant 2.6-fold for lifetime depressive disorders, a significant 2.7-fold for anxiety disorders and a nonsignificant 3.9-fold for behavioural disorders, after considering age, gender, ethnicity and home environment.

Among 44 patients with established bipolar disorder, the risk of having any prior anxiety disorder was increased nearly 9.7-fold compared with controls and 3.6-fold compared with at-risk individuals. Their risk of prior behavioural disorders was increased a significant 7.9-fold compared with controls whereas there was no significant difference compared with at-risk individuals.

“Our finding of an intermediate rate of psychopathology in the [at-risk] group – between the [bipolar disorder] and control samples – is consistent with this being a heterogeneous population, i.e. only a proportion will go on to later develop [bipolar disorder]”, comment Philip Mitchell (Prince of Wales Hospital, New South Wales, Australia) and co-researchers.

Contrary to previous reports neither anxiety disorders nor behavioural disorders predicted the onset of later affective disorders in the at-risk group, which the researchers suggest may be due to a limited sample size. However, prior behavioural disorders were significantly associated with the later onset of an affective disorder in those with established bipolar disorder.

“These findings suggest the potential for targeted preventive treatment of such prior conditions to reduce the later onset of affective disorders in subjects at increased genetic risk for [bipolar disorder]”, the researchers conclude in the Journal of Psychiatric Research.

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