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A controlled family study of children with DSM-IV bipolar-I disorder and psychiatric co-morbidity

Published online by Cambridge University Press:  06 November 2009

J. Wozniak ,
S. V. Faraone ,
E. Mick ,
M. Monuteaux ,
A. Coville  and
J. Biederman
J. Wozniak*
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital, Boston, MA, USA Department of Psychiatry at Harvard Medical School, Boston, MA, USA
S. V. Faraone
Affiliation:
Departments of Psychiatry and Neuroscience & Physiology, SUNY Upstate Medical University, NY, USA
E. Mick
Affiliation:
Department of Psychiatry at Harvard Medical School, Boston, MA, USA
M. Monuteaux
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital, Boston, MA, USA Department of Psychiatry at Harvard Medical School, Boston, MA, USA
A. Coville
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital, Boston, MA, USA
J. Biederman
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital, Boston, MA, USA Department of Psychiatry at Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: J. Wozniak, M.D., Massachusetts General Hospital, 55 Fruit St, Warren 705, Boston, MA02114, USA. (Email: [email protected])
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Abstract

Background

To estimate the spectrum of familial risk for psychopathology in first-degree relatives of children with unabridged DSM-IV bipolar-I disorder (BP-I).

Method

We conducted a blinded, controlled family study using structured diagnostic interviews of 157 children with BP-I probands (n=487 first-degree relatives), 162 attention deficit hyperactivity disorder (ADHD) (without BP-I) probands (n=511 first-degree relatives), and 136 healthy control (without ADHD or BP-I) probands (n=411 first-degree relatives).

Results

The morbid risk (MR) of BP-I disorder in relatives of BP-I probands (MR=0.18) was increased 4-fold [95% confidence interval (CI) 2.3–6.9, p<0.001] over the risk to relatives of control probands (MR=0.05) and 3.5-fold (95% CI 2.1–5.8, p<0.001) over the risk to relatives of ADHD probands (MR=0.06). In addition, relatives of children with BP-I disorder had high rates of psychosis, major depression, multiple anxiety disorders, substance use disorders, ADHD and antisocial disorders compared with relatives of control probands. Only the effect for antisocial disorders lost significance after accounted for by the corresponding diagnosis in the proband. Familial rates of ADHD did not differ between ADHD and BP-I probands.

Conclusions

Our results document an increased familial risk for BP-I disorder in relatives of pediatric probands with DSM-IV BP-I. Relatives of probands with BP-I were also at increased risk for other psychiatric disorders frequently associated with pediatric BP-I. These results support the validity of the diagnosis of BP-I in children as defined by DSM-IV. More work is needed to better understand the nature of the association between these disorders in probands and relatives.

Keywords

Bipolarchildrenfamily study
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 7 , July 2010 , pp. 1079 - 1088
Copyright
Copyright © Cambridge University Press 2009

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