Childhood and adolescence outcomes in offspring to parents with bipolar disorder: the impact of lifetime parental comorbidity, parental sex, and bipolar subtype

IF 6.5 1区医学 Q1 PSYCHIATRY Journal of Child Psychology and Psychiatry Pub Date : 2024-03-25 DOI:10.1111/jcpp.13982

Christine Takami Lageborn, Mengping Zhou, Marcus Boman, Arvid Sjölander, Henrik Larsson, Brian M. D'Onofrio, Erik Pettersson, Paul Lichtenstein, Mikael Landén

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Abstract

Background

Offspring of parents with bipolar disorder have increased risks of their own psychopathology. However, a large-scale survey of psychiatric, somatic, and adverse social outcomes up to adulthood, which could aid in prioritizing and tailoring prevention, is lacking. It also remains to clarify how risks are modified by other parental factors.

Methods

Swedish population registers were linked to compare offspring having (N = 24,788) and not having (N = 247,880) a parent with bipolar disorder with respect to psychiatric diagnoses and psychotropic medication, birth-related and somatic conditions, social outcomes, accidents, suicide attempts, and mortality. Individuals were followed until age 18. We estimated the influence of lifetime parental psychiatric comorbidity, bipolar disorder subtype, and sex on outcomes.

Results

Children of parents with bipolar disorder had 2–3 times higher risks of all psychiatric diagnoses, except for bipolar disorder, for which the risk was 11-fold. Significantly increased risks were also found for several somatic conditions, low school grades, criminal behavior, victimization, accidents, and suicidal behavior. Adjusting for lifetime parental psychiatric comorbidity attenuated most associations. Offspring of a parent with bipolar disorder type 2 had statistically significantly higher risks of attention deficit hyperactivity disorder, respiratory tract conditions, and accidents compared with offspring of a parent with bipolar disorder type 1. Offspring of mothers with bipolar disorder had higher risks of several psychiatric diagnoses, respiratory tract conditions, low school grades, and accidents compared with offspring of fathers with bipolar disorder. Having two parents with bipolar disorder entailed the highest risks of psychiatric outcomes in offspring.

Conclusions

Early intervention and family support are particularly warranted for the offspring of a parent with bipolar disorder in the presence of lifetime parental psychiatric comorbidity, when the parent has bipolar disorder type 2, or when the mother or both parents have bipolar disorder.

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父母患有躁郁症的后代在童年和青少年时期的结局：父母终生合并症、父母性别和躁郁症亚型的影响。

背景：双相情感障碍患者的后代患自身精神病理学的风险会增加。然而，目前还缺乏一项大规模的调查，调查对象包括直至成年的精神、躯体和不良社会后果，这有助于确定预防的优先次序和针对性。此外，父母的其他因素如何改变风险也有待澄清：方法：将瑞典的人口登记册联系起来，比较父母一方患有双相情感障碍的后代（24788 人）和父母一方未患有双相情感障碍的后代（247880 人）在精神病诊断和精神药物治疗、与出生有关的疾病和躯体疾病、社会后果、事故、自杀企图和死亡率方面的情况。我们对这些儿童进行了跟踪调查，直至他们年满 18 岁。我们估计了父母一生中的精神病合并症、双相情感障碍亚型和性别对结果的影响：结果：父母患有双相情感障碍的儿童被诊断为精神病的风险比其他儿童高 2-3 倍，但双相情感障碍除外，其风险是其他儿童的 11 倍。此外，几种躯体疾病、学习成绩差、犯罪行为、受害、事故和自杀行为的风险也显著增加。对父母一生中的精神病合并症进行调整后，大多数关联都会减弱。与患有双相情感障碍 1 型的父母的后代相比，患有双相情感障碍 2 型的父母的后代患注意缺陷多动障碍、呼吸道疾病和事故的风险在统计学上明显更高。与患有躁郁症的父亲的后代相比，患有躁郁症的母亲的后代患多种精神疾病、呼吸道疾病、学习成绩差和发生事故的风险更高。父母双方都患有躁郁症，其子女患精神病的风险最高：结论：如果父母终生都患有躁郁症，或者父母患有躁郁症 2 型，或者母亲或父母双方都患有躁郁症，则尤其需要对父母患有躁郁症的后代进行早期干预并提供家庭支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Child Psychology and Psychiatry 医学-精神病学

CiteScore

13.80

自引率

5.30%

发文量

169

审稿时长

1 months

期刊介绍： The Journal of Child Psychology and Psychiatry (JCPP) is a highly regarded international publication that focuses on the fields of child and adolescent psychology and psychiatry. It is recognized for publishing top-tier, clinically relevant research across various disciplines related to these areas. JCPP has a broad global readership and covers a diverse range of topics, including: Epidemiology: Studies on the prevalence and distribution of mental health issues in children and adolescents. Diagnosis: Research on the identification and classification of childhood disorders. Treatments: Psychotherapeutic and psychopharmacological interventions for child and adolescent mental health. Behavior and Cognition: Studies on the behavioral and cognitive aspects of childhood disorders. Neuroscience and Neurobiology: Research on the neural and biological underpinnings of child mental health. Genetics: Genetic factors contributing to the development of childhood disorders. JCPP serves as a platform for integrating empirical research, clinical studies, and high-quality reviews from diverse perspectives, theoretical viewpoints, and disciplines. This interdisciplinary approach is a key feature of the journal, as it fosters a comprehensive understanding of child and adolescent mental health. The Journal of Child Psychology and Psychiatry is published 12 times a year and is affiliated with the Association for Child and Adolescent Mental Health (ACAMH), which supports the journal's mission to advance knowledge and practice in the field of child and adolescent mental health.