Similar familial underpinnings for full and subsyndromal pediatric bipolar disorder: A familial risk analysis. (22nd May 2017)

• Record Type: Journal Article
• Authors: Wozniak, Janet; Uchida, Mai; Faraone, Stephen V; Fitzgerald, Maura; Vaudreuil, Carrie; Carrellas, Nicholas; Davis, Jacqueline; Wolenski, Rebecca; Biederman, Joseph
• Is Part Of: Bipolar disorders. Volume 19:Number 3(2017)
• Page Start: 168
• Page End: 175
• Publication Date: 2017-05-22
• Subjects: children -- familiality -- pediatric bipolar disorder -- subsyndromal; Manic-depressive illness -- Periodicals; Depression, Mental -- Periodicals; 616.895
• DOI: 10.1111/bdi.12494
• Languages: English
• ISSNs: 1398-5647

Abstract

Abstract : Objectives: To examine the validity of subthreshold pediatric bipolar I disorder (BP‐I), we compared the familial risk for BP‐I in the child probands who had either full BP‐I, subthreshold BP‐I, ADHD, or were controls that neither had ADHD nor bipolar disorder. Methods: BP‐I probands were youth aged 6−17 years meeting criteria for BP‐I, full (N=239) or subthreshold (N=43), and also included were their first‐degree relatives (N=687 and N=120, respectively). Comparators were youth with ADHD (N=162), controls without ADHD or bipolar disorder (N=136), and their first‐degree relatives (N=511 and N=411, respectively). We randomly selected 162 non‐bipolar ADHD probands and 136 non‐bipolar, non‐ADHD control probands of similar age and sex distribution to the BP‐I probands from our case−control ADHD family studies. Psychiatric assessments were made by trained psychometricians using the Kiddie Schedule for Affective Disorders and Schizophrenia for School‐Age Children Epidemiological Version (KSADS‐E) and Structured Clinical Interview for DSM‐IV (SCID) structured diagnostic interviews. We analyzed rates of bipolar disorder using multinomial logistic regression. Results: Rates of full BP‐I significantly differed between the four groups (χ 2 3 =32.72, P <.001): relatives of full BP‐I probands and relatives of subthreshold BP‐I probands had significantly higher rates of full BP‐I than relatives of ADHD probands and relatives of control probands. Relatives of full BP‐I, subthreshold BP‐I, and ADHD probands also had significantly higher rates of major depressive disorder compared to relatives of control probands. Conclusions: Our results showed that youth with subthreshold BP‐I had similarly elevated risk for BP‐I and major depressive disorder in first‐degree relatives as youth with full BP‐I. These findings support the diagnostic continuity between subsyndromal and fully syndromatic states of pediatric BP‐I disorder.