Offspring of parents with Bipolar Disorder are at increased risk for a range of psychopathology, including Bipolar Disorder, ADHD and disruptive behavior disorders and problems in their psychosocial and cognitive functioning. Familial aggregation of BD is associated with earlier age of onset, more frequent co-occurrence of other psychiatric disorders, more severe illness course.

To compare subsequent generations of BD patients in one family, taking account of a number of variables related to course of illness and patients’ functioning.

Twelve patients with

1. (1) Adolescent-diagnosed BD and

2. (2) BD in first-degree relatives in at least three generations, were analyzed. The first-degree relatives with Bipolar Disorder in each family were compared regarding: age of onset; cognitive functioning (WCST); social functioning; course of illness, medication response, co-occurrence of other psychiatric disorders.

In subsequent generations, familial aggregation of Bipolar Disorder was associated with: earlier age of onset; more severe episodes and co-occurrence of other psychiatric disorders; worse medication response (Lithium) for a part of families; lower cognitive and social functioning.

In order to reduce the risk for long-term functional impairment in offspring, interventions addressing parental functioning and early interventions targeting the child's psychopathology should be introduced.