TY - JOUR
T1 - A high-risk study of bipolar disorder
T2 - Childhood clinical phenotypes as precursors of major mood disorders
AU - Nurnberger, John I.
AU - McInnis, Melvin
AU - Reich, Wendy
AU - Kastelic, Elizabeth
AU - Wilcox, Holly C.
AU - Glowinski, Anne
AU - Mitchell, Philip
AU - Fisher, Carrie
AU - Erpe, Mariano
AU - Gershon, Elliot S.
AU - Berrettini, Wade
AU - Laite, Gina
AU - Schweitzer, Robert
AU - Rhoadarmer, Kelly
AU - Coleman, Vegas V.
AU - Cai, Xueya
AU - Azzouz, Faouzi
AU - Liu, Hai
AU - Kamali, Masoud
AU - Brucksch, Christine
AU - Monahan, Patrick O.
PY - 2011/10
Y1 - 2011/10
N2 - Context: The childhood precursors of adult bipolar disorder (BP) are still a matter of controversy. Objective: To report the lifetime prevalence and early clinical predictors of psychiatric disorders in offspring from families of probands with DSM-IV BP compared with offspring of control subjects. Design: A longitudinal, prospective study of individuals at risk for BP and related disorders. We report initial (cross-sectional and retrospective) diagnostic and clinical characteristics following best-estimate procedures. Setting: Assessment was performed at 4 university medical centers in the United States between June 1, 2006, and September 30, 2009. Participants: Offspring aged 12 to 21 years in families with a proband with BP (n=141, designated as cases) and similarly aged offspring of control parents (n=91). Main Outcome Measure: Lifetime DSM-IV diagnosis of a major affective disorder (BP type I; schizoaffective disorder, bipolar type; BP type II; or major depression). Results: At a mean age of 17 years, cases showed a 23.4% lifetime prevalence of major affective disorders compared with 4.4% in controls (P=.002, adjusting for age, sex, ethnicity, and correlation between siblings). The prevalence of BP in cases was 8.5% vs 0% in controls (adjusted P=.007). No significant difference was seen in the prevalence of other affective, anxiety, disruptive behavior, or substance use disorders. Among case subjects manifesting major affective disorders (n=33), there was an increased risk of anxiety and externalizing disorders compared with cases without mood disorder. In cases but not controls, a childhood diagnosis of an anxiety disorder (relative risk=2.6; 95% CI, 1.1-6.3; P=.04) or an externalizing disorder (3.6; 1.4-9.0; P=.007) was predictive of later onset of major affective disorders. Conclusions: Childhood anxiety and externalizing diagnoses predict major affective illness in adolescent offspring in families with probands with BP.
AB - Context: The childhood precursors of adult bipolar disorder (BP) are still a matter of controversy. Objective: To report the lifetime prevalence and early clinical predictors of psychiatric disorders in offspring from families of probands with DSM-IV BP compared with offspring of control subjects. Design: A longitudinal, prospective study of individuals at risk for BP and related disorders. We report initial (cross-sectional and retrospective) diagnostic and clinical characteristics following best-estimate procedures. Setting: Assessment was performed at 4 university medical centers in the United States between June 1, 2006, and September 30, 2009. Participants: Offspring aged 12 to 21 years in families with a proband with BP (n=141, designated as cases) and similarly aged offspring of control parents (n=91). Main Outcome Measure: Lifetime DSM-IV diagnosis of a major affective disorder (BP type I; schizoaffective disorder, bipolar type; BP type II; or major depression). Results: At a mean age of 17 years, cases showed a 23.4% lifetime prevalence of major affective disorders compared with 4.4% in controls (P=.002, adjusting for age, sex, ethnicity, and correlation between siblings). The prevalence of BP in cases was 8.5% vs 0% in controls (adjusted P=.007). No significant difference was seen in the prevalence of other affective, anxiety, disruptive behavior, or substance use disorders. Among case subjects manifesting major affective disorders (n=33), there was an increased risk of anxiety and externalizing disorders compared with cases without mood disorder. In cases but not controls, a childhood diagnosis of an anxiety disorder (relative risk=2.6; 95% CI, 1.1-6.3; P=.04) or an externalizing disorder (3.6; 1.4-9.0; P=.007) was predictive of later onset of major affective disorders. Conclusions: Childhood anxiety and externalizing diagnoses predict major affective illness in adolescent offspring in families with probands with BP.
UR - http://www.scopus.com/inward/record.url?scp=80053542442&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80053542442&partnerID=8YFLogxK
U2 - 10.1001/archgenpsychiatry.2011.126
DO - 10.1001/archgenpsychiatry.2011.126
M3 - Article
C2 - 21969459
AN - SCOPUS:80053542442
SN - 0003-990X
VL - 68
SP - 1012
EP - 1020
JO - Archives of general psychiatry
JF - Archives of general psychiatry
IS - 10
ER -