Familial risk for bipolar I disorder is associated with erythrocyte omega-3 polyunsaturated fatty acid deficits in youth with attention-deficit hyperactivity disorder. (July 2022)

• Record Type: Journal Article
• Authors: McNamara, Robert K.; Chen, Constance; Tallman, Maxwell J.; Schurdak, Jennifer D.; Patino, L. Rodrigo; Blom, Thomas J.; DelBello, Melissa P.
• Is Part Of: Psychiatry research. Volume 313(2022)
• Publication Date: 2022-07
• Subjects: Bipolar I disorder -- Family history -- Mania -- Risk -- Fatty Acids; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2022.114587
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: ADHD and a family history of bipolar I disorder (BD) are risk factors for developing BD in youth. Developmental omega-3 polyunsaturated fatty acid ( n -3 PUFA) deficiency is a putative risk factor for BD. ADHD youth with a BD family history exhibit a more severe clinical profile, including greater manic symptoms, compared with ADHD youth without a BD family history. ADHD youth with, but not without, a BD family history also exhibit erythrocyte n -3 PUFA deficits. Abstract: Although attention-deficit/hyperactivity disorder (ADHD) and a family history of bipolar I disorder (BD) increase the risk for developing BD, associated pathoetiological mechanisms remain poorly understood. One candidate risk factor is a neurodevelopmental deficiency in omega-3 polyunsaturated fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). This study investigated erythrocyte EPA+DHA biostatus in psychostimulant-free ADHD youth with ('high-risk', HR) and without ('low-risk', LR) a first-degree relative with BD, and healthy controls (HC). Erythrocyte EPA+DHA composition was determined by gas chromatography, and symptom ratings were performed. A total of n = 123 (HR, n = 41; LR, n = 42; HC, n = 40) youth (mean age: 14.4 ± 2.5 years) were included in the analysis. Compared with HC, erythrocyte EPA+DHA composition was significantly lower in HR (-13%) but not LR (-3%), and there was a trend for HR to be lower than LR (-11%). Both HR and LR differed significantly from HC on all symptom ratings. HR had greater ADHD hyperactivity/impulsive symptom severity, manic symptom severity, and higher parent-reported ratings of internalization, externalization, and dysregulation, compared with LR. ADHD youth with a BD family history exhibit erythrocyte EPA+DHA deficits and a more severe clinical profile, including greater manic and dysregulation symptoms, compared with ADHD youth without a BD family history.