A Longitudinal Study of Psychiatric Disorders in Offspring of Parents With Bipolar Disorder From Preschool to Adolescence.

Abstract OBJECTIVE To compare the prevalence of psychopathology, particularly bipolar disorder (BD), between preschool offspring of parents with BD and community controls. METHOD 116 offspring of BD-I/II parents and 98 controls (53 parents with non-BD psychopathology and 45 healthy parents) were recruited at ages 2-5 years and followed on average 9.6 years (on average: 2-5:1.6 times; after age 5:4 times) (average ages at intake/last follow-up: 3.8/13.4, retention:98%). Participants were evaluated with standardized instruments blind to parental diagnoses. RESULTS After adjusting for confounders, offspring of BD parents only showed more attention-deficit/hyperactivity disorder (ADHD) during ages 2-5 than the other two groups. After age 5, offspring of BD parents did not differ from offspring of parents with non-BD psychopathology, but they had more anxiety, ADHD, and behavior problems than offspring of healthy parents. Only offspring of BD parents developed BD-I/II: 3.4% (n=4) and BD-Not-Otherwise-Specified (BD-NOS):11.2% (n=13), with mean onset ages 11.4 and 7.4, respectively. About 70% of offspring with BD had non-BD disorders before BD. Only ADHD, diagnosed before age 6, and early onset parental BD were significantly associated with BD risk. CONCLUSION Most offspring of BD parents did not develop BD, but they were at specific high risk to develop BD, particularly those with preschool ADHD and early onset parental BD. BD symptoms were scarce during the preschool years and increased throughout the school-age, mainly in the form of BD-NOS, a disorder that conveys poor prognosis and high risk to develop BD-I/II. Developing early interventions to delay or, ideally, prevent its onset are warranted.