Mental Disorders in Offspring of Parents with Bipolar Disorder

Young Sung Cho; Hwa-Young Lee; Young-Joon Kwon; Hee-Yeun Jeong; Jung-Yi Shin; Se-Hoon Shim

doi:10.4306/jknpa.2014.53.5.310

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Cho, Lee, Kwon, Jeong, Shin, and Shim: Mental Disorders in Offspring of Parents with Bipolar Disorder

Original Article

Journal of Korean Neuropsychiatric Association 2014; 53(5): 310-319.

Published online: 29 September 2014

DOI: https://doi.org/10.4306/jknpa.2014.53.5.310

Mental Disorders in Offspring of Parents with Bipolar Disorder

Young Sung Cho, MD, Hwa-Young Lee, MD, PhD, Young-Joon Kwon, MD, PhD, Hee-Yeun Jeong, MD, PhD, Jung-Yi Shin, PhD, Se-Hoon Shim, MD, PhD

Department of Psychiatry, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea.

Address for correspondence: Se-Hoon Shim, MD, PhD. Department of Psychiatry, Cheonan Hospital, Collage of Medicine, Soonchunhyang University, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 330-930, Korea. Tel +82-41-570-3853, Fax +82-41-592-3804, shshim2k@daum.net

Received 19 May 2014 Revised 5 June 2014 Accepted 4 August 2014

Abstract

Objectives

Information on the specificity of associations between parents with bipolar disorder (BPD) and risk of psychopathology in their offspring is limited. The aim of this study was to examine the prevalence of mental disorders in the offspring of individuals with BPD in South Korea.

Methods

The sample consisted of 100 child and adolescent offspring (aged 6.0-18.9 years) from 65 nuclear families having at least one parent with BPD. Probands, offspring, and biological co-parents were interviewed using a semi-structured diagnostic interview and the offspring were evaluated using the Korean version of the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL).

Results

Sixty one of the 100 participants met the criteria for at least one mental disorder. Of these, 35 participants had a mood disorder, 35 had an anxiety disorder, and 29 had attention-deficit hyperactivity disorder (ADHD). Thirty nine of the offspring had no psychiatric diagnosis. Of the 35 with a mood disorder, 16 (45.7%) had comorbid ADHD and 18 (51.4%) had comorbid anxiety disorders.

Conclusion

Offspring of parents with BPD are at high risk for mental disorders. These findings further support the heredity of BPD and indicate the need for early identification and treatment.

Keywords: Bipolar disorder, Offspring, Child , Adolescent

Figures and Tables

Figure 1

Incidence of mental disorders classified by age and sex of offspring (n=100). ADHD: Attention-deficit hyperactivity disorder, DBD: Disruptive behavior disorders, MDD: Major depressive disorder, NOS: Not otherwise specified.

Table 1-1

Demographic characteristics of parents (n=65)

SD: Standard deviation

Table 1-2

Demographics and clinical characteristics of offspring (n=100)

ARS: Attention-Deficit Hyperactivity Disorder Rating-Scale, CDI: Children's Depression Inventory, MDQ: Mood Disorders Questionnaire, RCMAS: The Revised Children Manifest Anxiety Scale, SD: Standard deviation

Table 2

Primary and comorbid diagnoses of the offspring of parents with bipolar disorder (n=100)

^*: Comorbidities are possible. ADHD: Attention-deficit hyperactivity disorder, DBD: Disruptive behavior disorders, MDD: Major depressive disorder, NOS: Not otherwise specified

Table 3

Comparison of primary diagnoses of the offspring of parents with bipolar I and II disorders (n=100)

^*: Comorbidities are possible. ADHD: Attention-deficit hyperactivity disorder, BID: Bipolar I disorder, BIID: Bipolar II disorder, DBD: Disruptive behavior disorders, MDD: Major depressive disorder, NOS: Not otherwise specified

Table 4

Incidence of mental disorders classified by age and sex of offspring (n=100)

^*: Comorbidities are possible. ADHD: Attention-deficit hyperactivity disorder, DBD: Disruptive behavior disorders, MDD: Major depressive disorder, NOS: Not otherwise specified

Table 5

Family psychiatric histories of the offspring of bipolar parents (n=65)

^*: Comorbidities are possible, ^†: Spouse of the bipolar informant parent. ADHD: Attention-deficit hyperactivity disorder

Notes

The authors have no financial conflicts of interest.

References

1. Weissman MM, Gammon GD, John K, Merikangas KR, Warner V, Prusoff BA, et al. Children of depressed parents. Increased psychopathology and early onset of major depression. Arch Gen Psychiatry. 1987; 44:847–853.

2. Hammen C, Gordon D, Burge D, Adrian C, Jaenicke C, Hiroto D. Maternal affective disorders, illness, and stress: risk for children's psychopathology. Am J Psychiatry. 1987; 144:736–741.

3. Lapalme M, Hodgins S, LaRoche C. Children of parents with bipolar disorder: a metaanalysis of risk for mental disorders. Can J Psychiatry. 1997; 42:623–631.

4. Chang KD, Steiner H, Ketter TA. Psychiatric phenomenology of child and adolescent bipolar offspring. J Am Acad Child Adolesc Psychiatry. 2000; 39:453–460.

5. Hillegers MH, Reichart CG, Wals M, Verhulst FC, Ormel J, Nolen WA. Five-year prospective outcome of psychopathology in the adolescent offspring of bipolar parents. Bipolar Disord. 2005; 7:344–350.

6. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997; 36:980–988.

7. Kim YS, Cheon KA, Kim BN, Chang SA, Yoo HJ, Kim JW, et al. The reliability and validity of Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean version (K-SADS-PL-K). Yonsei Med J. 2004; 45:81–89.

8. Hirschfeld RM, Williams JB, Spitzer RL, Calabrese JR, Flynn L, Keck PE Jr, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry. 2000; 157:1873–1875.

9. Jon DI, Yoon BH, Jung HY, Ha KS, Shin YC, Bahk WM. A validation study of the Korean Version Mood Disorder Questionnaire (K-MDQ). J Korean Neuropsychiatr Assoc. 2005; 44:583–590.

10. DuPaul GJ. Parent and teacher ratings of ADHD symptoms: psychometric properties in a community-based sample. J Clin Child Adolesc Psychol. 1991; 20:245–253.

11. So YK, Noh JS, Kim YS, Ko SG, Koh YJ. The reliability and validity of Korean parent and teacher ADHD Rating Scale. J Korean Neuropsychiatr Assoc. 2002; 41:283–289.

12. Kovacs M. The children's depression inventory: a self-rating depression scale for school-aged youngsters. Pittsburgh, PA: University of Pittsburgh;1982.

13. Cho S, Lee Y. Development of the Korean form of the Kovacs' Children's Depression Inventory. J Korean Neuropsychiatr Assoc. 1990; 29:943–956.

14. Castaneda A, McCandless BR, Palermo DS. The children's form of the manifest anxiety scale. Child Dev. 1956; 27:317–326.

15. Reynolds CR, Richmond BO. Revised Children's Manifest Anxiety Scale (RCMAS): Manual. Los Angeles: WPS, Western Psychological Services;1985.

16. Cho S, Choi J. Development of the Korean form of the state-trait anxiety inventory for children. Seoul J Psychiatry. 1989; 117:150–157.

17. Vandeleur C, Rothen S, Gholam-Rezaee M, Castelao E, Vidal S, Favre S, et al. Mental disorders in offspring of parents with bipolar and major depressive disorders. Bipolar Disord. 2012; 14:641–653.

18. Zappitelli MC, Bordin IA, Hatch JP, Caetano SC, Zunta-Soares G, Olvera RL, et al. Lifetime psychopathology among the offspring of Bipolar I parents. Clinics (Sao Paulo). 2011; 66:725–730.

19. Singh MK, DelBello MP, Stanford KE, Soutullo C, McDonough-Ryan P, McElroy SL, et al. Psychopathology in children of bipolar parents. J Affect Disord. 2007; 102:131–136.

20. Birmaher B, Axelson D, Monk K, Kalas C, Goldstein B, Hickey MB, et al. Lifetime psychiatric disorders in school-aged offspring of parents with bipolar disorder: the Pittsburgh Bipolar Offspring study. Arch Gen Psychiatry. 2009; 66:287–296.

21. Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010; 49:980–989.

22. Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, et al. Childhood and adolescent depression: a review of the past 10 years. Part I. J Am Acad Child Adolesc Psychiatry. 1996; 35:1427–1439.

23. Jane Costello E, Erkanli A, Angold A. Is there an epidemic of child or adolescent depression? J Child Psychol Psychiatry. 2006; 47:1263–1271.

24. Duffy A, Alda M, Crawford L, Milin R, Grof P. The early manifestations of bipolar disorder: a longitudinal prospective study of the offspring of bipolar parents. Bipolar Disord. 2007; 9:828–838.

25. Duffy A, Alda M, Hajek T, Grof P. Early course of bipolar disorder in high-risk offspring: prospective study. Br J Psychiatry. 2009; 195:457–458.

26. Townsend LD, Demeter CA, Wilson M, Findling RL. Update on pediatric bipolar disorder. Curr Psychiatry Rep. 2007; 9:529–534.

27. Tillman R, Geller B. Diagnostic characteristics of child bipolar I disorder: does the "Treatment of Early Age Mania (team)" sample generalize? J Clin Psychiatry. 2007; 68:307–314.

28. Wozniak J, Biederman J, Kwon A, Mick E, Faraone S, Orlovsky K, et al. How cardinal are cardinal symptoms in pediatric bipolar disorder? An examination of clinical correlates. Biol Psychiatry. 2005; 58:583–588.

29. Geller B, Warner K, Williams M, Zimerman B. Prepubertal and young adolescent bipolarity versus ADHD: assessment and validity using the WASH-U-KSADS, CBCL and TRF. J Affect Disord. 1998; 51:93–100.

30. Geller B, Zimerman B, Williams M, Delbello MP, Bolhofner K, Craney JL, et al. DSM-IV mania symptoms in a prepubertal and early adolescent bipolar disorder phenotype compared to attention-deficit hyperactive and normal controls. J Child Adolesc Psychopharmacol. 2002; 12:11–25.

31. Biederman J, Faraone SV, Chu MP, Wozniak J. Further evidence of a bidirectional overlap between juvenile mania and conduct disorder in children. J Am Acad Child Adolesc Psychiatry. 1999; 38:468–476.

32. Faraone SV, Biederman J, Wozniak J, Mundy E, Mennin D, O'Donnell D. Is comorbidity with ADHD a marker for juvenile-onset mania? J Am Acad Child Adolesc Psychiatry. 1997; 36:1046–1055.

33. Carlson GA. Classification issues of bipolar disorders in childhood. Psychiatr Dev. 1984; 2:273–285.

34. Craighead WE, Smucker MR, Craighead LW, Ilardi SS. Factor analysis of the Children's Depression Inventory in a community sample. Psychol Assessment. 1998; 10:156–165.

35. Park JI. Factor analysis of Children's Depression Inventory: in a population of general children in a small city in Korea. J Korean Neuropsychiatr Assoc. 2008; 47:555–560.

36. Choi J, Cho S. Assessment of anxiety in children raliability and validity of Revised Children's Manifest Anxiety Scale. J Korean Neuropsychiatr Assoc. 1990; 29:691–702.

37. Gershon ES, Hamovit J, Guroff JJ, Dibble E, Leckman JF, Sceery W, et al. A family study of schizoaffective, bipolar I, bipolar II, unipolar, and normal control probands. Arch Gen Psychiatry. 1982; 39:1157–1167.

38. Andreasen NC, Rice J, Endicott J, Coryell W, Grove WM, Reich T. Familial rates of affective disorder. A report from the National Institute of Mental Health Collaborative Study. Arch Gen Psychiatry. 1987; 44:461–469.

39. Heun R, Maier W. The distinction of bipolar II disorder from bipolar I and recurrent unipolar depression: results of a controlled family study. Acta Psychiatr Scand. 1993; 87:279–284.

40. Angst J. The course of affective disorders. Psychopathology. 1986; 19:Suppl 2. 47–52.

41. Peselow ED, Dunner DL, Fieve RR, Deutsch SI, Rubinstein ME. Age of onset of affective illness. Psychiatr Clin (Basel). 1982; 15:124–132.

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