Article

Diagnoses in school-age children of bipolar affective disorder patients and normal controls

Journal of Affective Disorders (Impact Factor: 3.38). 05/1985; 8(3):283-91. DOI: 10.1016/0165-0327(85)90028-X
Source: PubMed

ABSTRACT

A family study of psychiatric diagnoses was performed in 29 children of bipolar patients and 37 children of normal controls, ages 6-17. There were no differences in major or minor affective diagnoses between the patient and control groups, but there was an increase of non-specific diagnoses in the patient group. Using DSM-III criteria, 10% of patients' children and 14% of controls' children had had at least one episode of major depression. This suggests that major depression in children is not familially related to adult bipolar major affective disorder. The observed prevalence of depression in childhood is increased when both direct interview of children and interview of parents are performed.

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    • "A BPI subtype characterized by high rates of co-morbid drug and alcohol abuse or dependence (Sonne & Brady, 1999; Nurnberger et al. 2007) has shown evidence for elevated genetic predisposition to substance use disorders (Winokur et al. 1970, 1995, 1996; Helzer & Winokur, 1974; Morrison, 1974, 1975; Gershon et al. 1982; Kendler et al. 1993; Feinman & Dunner, 1996; Maier & Merikangas, 1996; Duffy et al. 1998; DelBello et al. 1999; Strakowski & DelBello, 2000; Nurnberger et al. 2007). Finally, offspring of BPI patients (compared with controls) have higher rates of affective, anxiety and externalizing disorders such as conduct disorder, oppositional disorder and substance abuse (Gershon et al. 1985; Nurnberger et al. 1988, 2011; Todd et al. 1996; Lapalme et al. 1997; Chang et al. 2000, 2003; DelBello & Geller, 2001). Factor analysis and cluster analysis are complementary methods for investigating BPI clinical subtypes. "

    No preview · Article · Jul 2015 · Psychological Medicine
    • "A BPI subtype characterized by high rates of co-morbid drug and alcohol abuse or dependence (Sonne & Brady, 1999; Nurnberger et al. 2007) has shown evidence for elevated genetic predisposition to substance use disorders (Winokur et al. 1970, 1995, 1996; Helzer & Winokur, 1974; Morrison, 1974, 1975; Gershon et al. 1982; Kendler et al. 1993; Feinman & Dunner, 1996; Maier & Merikangas, 1996; Duffy et al. 1998; DelBello et al. 1999; Strakowski & DelBello, 2000; Nurnberger et al. 2007). Finally, offspring of BPI patients (compared with controls) have higher rates of affective, anxiety and externalizing disorders such as conduct disorder, oppositional disorder and substance abuse (Gershon et al. 1985; Nurnberger et al. 1988, 2011; Todd et al. 1996; Lapalme et al. 1997; Chang et al. 2000, 2003; DelBello & Geller, 2001). Factor analysis and cluster analysis are complementary methods for investigating BPI clinical subtypes. "
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    ABSTRACT: The first aim was to use confirmatory factor analysis (CFA) to test a hypothesis that two factors (internalizing and externalizing) account for lifetime co-morbid DSM-IV diagnoses among adults with bipolar I (BPI) disorder. The second aim was to use confirmatory latent class analysis (CLCA) to test the hypothesis that four clinical subtypes are detectible: pure BPI; BPI plus internalizing disorders only; BPI plus externalizing disorders only; and BPI plus internalizing and externalizing disorders. A cohort of 699 multiplex BPI families was studied, ascertained and assessed (1998-2003) by the National Institute of Mental Health Genetics Initiative Bipolar Consortium: 1156 with BPI disorder (504 adult probands; 594 first-degree relatives; and 58 more distant relatives) and 563 first-degree relatives without BPI. Best-estimate consensus DSM-IV diagnoses were based on structured interviews, family history and medical records. MPLUS software was used for CFA and CLCA. The two-factor CFA model fit the data very well, and could not be improved by adding or removing paths. The four-class CLCA model fit better than exploratory LCA models or post-hoc-modified CLCA models. The two factors and four classes were associated with distinctive clinical course and severity variables, adjusted for proband gender. Co-morbidity, especially more than one internalizing and/or externalizing disorder, was associated with a more severe and complicated course of illness. The four classes demonstrated significant familial aggregation, adjusted for gender and age of relatives. The BPI two-factor and four-cluster hypotheses demonstrated substantial confirmatory support. These models may be useful for subtyping BPI disorders, predicting course of illness and refining the phenotype in genetic studies.
    No preview · Article · Jun 2015 · Psychological Medicine
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    • "Based on these earlier findings, we hypothesized that: (i) high-risk offspring would develop a broad spectrum of psychiatric disorders and mood disorders in particular; (ii) in a substantial proportion of high-risk offspring, mood disorders Table 1. Parent characteristics in published high-risk studies Study Proband parent diagnosis Setting Sex Psychiatric status of other parent Gershon et al. 1985 (87) BD I Unspecified 41.4% of offspring had one bipolar parent and one parent with an unspecified diagnosis Klein et al. 1985 (88) BD I Inpatients M, F 25% other parents affected Laroche et al. 1989 (89) "
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    ABSTRACT: A major aim of this longitudinal high-risk study is to identify reliable early indicators of emerging bipolar disorder (BD) among offspring from well-characterized parents. High-risk offspring were recruited from families in which one parent had BD diagnosed on the basis of the Schedule for Affective Disorders and Schizophrenia - Lifetime version (SADS-L) interviews and DSM-IV diagnostic criteria and the other parent was well. Bipolar parents were further subdivided on the basis of response or non-response to long-term lithium. A comparison group of offspring was recruited from well parents diagnosed on the basis of either SADS-L interviews or the family history method. All consenting offspring from high-risk and control families were assessed longitudinally with the Schedule for Affective Disorders and Schizophrenia for School-aged Children - Present and Lifetime version (KSADS-PL) interviews and DSM-IV diagnoses were made on a blind consensus review. The offspring were reassessed on average annually, as well as at any time symptoms developed. Antecedent conditions to BD in both high-risk groups included sleep and anxiety disorders, while attention-deficit hyperactivity disorder and pre-psychotic conditions were antecedents among the offspring of lithium non-responders only. Among those offspring developing BD, the index mood episode was almost always depressive. Despite a specific genetic risk, BD began with non-specific psychopathology and/or depressive disorders in a majority of offspring. Therefore, diagnosis based only on cross-sectional assessment of symptoms appears to be insufficient for the accurate early detection of emerging BD. Other parameters such as family history and associated antecedents should be taken into account.
    Full-text · Article · Jan 2008 · Bipolar Disorders
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