 |
|
Controlled, Blindly Rated, Direct-Interview Family Study of a Prepubertal and Early-Adolescent Bipolar I Disorder Phenotype
Morbid Risk, Age at Onset, and Comorbidity
Barbara Geller, MD;
Rebecca Tillman, MS;
Kristine Bolhofner, BS;
Betsy Zimerman, MA;
Nancy A. Strauss, BSN;
Patricia Kaufmann, MSN
Arch Gen Psychiatry. 2006;63:1130-1138.
Context A key question is whether a prepubertal and early-adolescent bipolar I disorder phenotype (PEA–BP-I) is the same illness as adult BP-I. This question arises because of the greater severity, longer current episode duration, preponderance of mania, and high rates of ultradian rapid cycling and comorbid attention-deficit/hyperactivity disorder (ADHD) in PEA–BP-I.
Objectives To examine morbid risk (MR) of BP-I in first-degree relatives of PEA–BP-I, ADHD, and healthy control probands, as well as imprinting, sibling recurrence risk, and anticipation.
Design Controlled, blind direct interview. There were no family psychopathology exclusions for any proband group.
Setting University medical school research unit.
Participants First-degree relatives 6 years and older (n = 690) of 219 probands (95 with PEA–BP-I, 47 with ADHD, and 77 healthy controls). The PEA–BP-I and ADHD probands were obtained by consecutive new case ascertainment, and healthy controls were from a random survey; proband diagnoses were validated via 4-year prospective follow-up. The PEA–BP-I probands had a mean ± SD age of 10.8 ± 2.6 years.
Main Outcome Measure Morbid risk.
Results The MR of BP-I was higher in relatives of PEA–BP-I probands compared with ADHD or healthy controls (P<.001 for both); the MR in relatives of ADHD and healthy controls was similar. The MR of BP-I in relatives with ADHD was higher (P<.001) and age at onset of BP-I was younger in parents with ADHD than in those without (P<.001). The MR of BP-I in relatives with oppositional, conduct, or antisocial disorders was higher than in those without (P<.001). Anticipation was evidenced by a younger age at onset of BP-I in probands than in their parents (P<.001). No imprinting was found.
Conclusions Findings support that PEA–BP-I and adult BP-I are the same diathesis, 7 to 8x greater familiality in child vs adult BP-I, and family study validation of PEA–BP-I, including its differentiation from ADHD.
Author Affiliations: Department of Psychiatry, Washington University in St Louis, St Louis, Mo.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
National Trends in the Outpatient Diagnosis and Treatment of Bipolar Disorder in Youth
Moreno et al.
Arch Gen Psychiatry 2007;64:1032-1039.
ABSTRACT
| FULL TEXT
Authors' reply:
Asherson et al.
Br. J. Psychiatry 2007;191:182-182.
FULL TEXT
Differentiation in the Preonset Phases of Schizophrenia and Mood Disorders: Evidence in Support of a Bipolar Mania Prodrome
Correll et al.
Schizophr Bull 2007;0:sbm028v1-1.
ABSTRACT
| FULL TEXT
Bipolar I disorder is common in first-degree relatives of children with prepubertal and early adolescent bipolar I disorder
Wozniak
Evid. Based Ment. Health 2007;10:63-63.
FULL TEXT
|
