Children who have a parent with bipolar disorder are more likely to develop attention-deficit/
“[Bipolar disorder] symptoms were scarce during the preschool years and increased throughout [early adolescence],” wrote Boris Birmaher, M.D., of the University of Pittsburgh School of Medicine and colleagues. “Developing early interventions to delay or, ideally, prevent [bipolar disorder] onset are warranted.”
Birmaher and colleagues recruited 116 children who had a parent with either bipolar I or II disorder (BD-I/II parents), 53 children of parents with a non-bipolar psychiatric disorder (non-BD parents), and 45 children of parents with no psychiatric disorder (healthy parents) for the study. All children were between the ages of 2 and 5 years at the start of the study and were periodically assessed for about 10 years using the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version (KSADS-PL).
The researchers found that the children of BD-I/II parents were significantly more likely to have ADHD by age 5 (21.6% of children) than children of non-BD parents (3.8%) and children of healthy parents (2.2%). After age 5, children of BD-I/II parents and non-BD parents showed no statistical difference in rates of non-bipolar psychiatric disorders. However, compared with children of healthy parents, children of BD-I/II parents had elevated rates of anxiety, ADHD, and behavior problems after age 5.
During the study period, 17 of the children of parents with BD-I/II (about 15%) were diagnosed with bipolar disorder; four children developed BD-I/II and 13 developed BD-Not-Otherwise-Specified (BD-NOS), with an average age of onset of 11.4 and 7.4 years, respectively. (BD-NOS is typically diagnosed in people who show bipolar mood swings but the timing and/or intensity do not meet the full criteria of BD-I or BD-II.) None of the children in the other groups received a diagnosis of bipolar disorder during the study.
“Given that youth with BD-NOS exhibit as much psychosocial impairment, suicide risk, substance abuse, comorbid disorders, and family history of BD as youths with BD-I/II, and are at very high risk to transition into BD-I/II (particularly if they have family history of BD), the diagnosis of BD-NOS warrants significant clinical consideration,” Birmaher and colleagues wrote.
The researchers looked over the data to see which factors might help predict the youth who would develop bipolar disorder; the only significant risk factors they identified were an ADHD diagnosis before age 6 and having parents with early onset bipolar disorder.
To read more on this topic, see the Psychiatric News article “Study Sheds Light on Trajectory of Developing Bipolar Disorder.”