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Similar familial underpinnings for full and subsyndromal pediatric bipolar disorder: A familial risk analysis
Author(s) -
Wozniak Janet,
Uchida Mai,
Faraone Stephen V,
Fitzgerald Maura,
Vaudreuil Carrie,
Carrellas Nicholas,
Davis Jacqueline,
Wolenski Rebecca,
Biederman Joseph
Publication year - 2017
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12494
Subject(s) - bipolar disorder , proband , bipolar i disorder , psychiatry , medicine , first degree relatives , psychology , schedule for affective disorders and schizophrenia , clinical psychology , mania , family history , mood , genetics , anxiety , biology , mutation , gene
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.