[Children of parents with bipolar disorder]. / Kinderen van ouders met een bipolaire stoornis.

BACKGROUND: Bipolar disorder runs in families. The illness is partly genetically determined and develops in conjunction with psychosocial factors. aim To describe what is known about the psychopathology and the functioning of children whose parents suffer from bipolar disorder and to examine the early symptoms and possible predictors of bipolar disorder. METHOD: We describe a prospective study in the Netherlands among 140 children from 86 families in which one parent had bipolar disorder. The results of this study are compared with results that have appeared in the existing literature. results Over a period of five years the children of bipolar parents run a high risk of developing mood disorders and especially bipolar disorder. The onset and course of self-reported affective problems and depression were found to be predictors for the development of bipolar disorders. The General Behavior Inventory was found to be a useful tool for the early detection of bipolar disorder. conclusion It is important that the children of bipolar parents be monitored intensively, particularly if they have from mood swings or depression.

Perceived parental rearing of bipolar offspring.

OBJECTIVE: To explore the impact of growing up with a parent with a bipolar disorder. First, we compared parental rearing behavior perceived by young adult offspring of bipolar parents with parental rearing behavior perceived by same aged young adults from the general population. Secondly, we examined the associations between perceived parental rearing behavior and parental psychopathology and psychopathology in offspring. METHOD: Subjects were 129 offspring of 80 bipolar parents and their spouses and 1122 young adults from the general population. In offspring the Structured Clinical Interview for DSM-IV was used to assess DSM-IV diagnoses and the EMBU was used to assess perceived parental rearing in both groups. RESULTS: In general, offspring growing up in a family with a bipolar parent perceived their mothers as less rejecting, more emotionally warm and less overprotecting and their fathers as less emotionally warm and less overprotecting compared with young adults from the general population. Perceived rejection was related to psychopathology in offspring. CONCLUSION: Overall, parental rearing in families with a parent with a bipolar disorder is not more dysfunctional, as perceived by their offspring, than in families from the general population. Offspring with a bipolar disorder perceive their parents as more rejecting.

Prediction of change in level of problem behavior among children of bipolar parents.

OBJECTIVE: To determine the effects of familial loading, birth weight, and family problems on change in parent-reported problems across a 14-month period among children of bipolar parents. METHOD: Emotional and behavioral problems in a sample of 140 offspring of bipolar parents and familial loading in first- and second-degree relatives were assessed at two measurements. Parents reported the birth weight of their offspring and completed a questionnaire on family problems. Multiple linear regression analyses were performed to assess associations of the three predictors with change in problem scores at follow-up. RESULTS: Familial loading of unipolar disorder was a unique predictor for an increase in problem scores from the first to the second measurement with beta-coefficients ranging from 0.17 to 0.25. Birth weight and family problems were not associated with change in problem scores across the two measurements. CONCLUSION: Familial loading of unipolar disorder predicted an increase in behavioral and emotional problems across the 14-month follow-up.

Prevalence of psychopathology in children of a bipolar parent.

OBJECTIVE: To determine psychopathology in adolescent children of a bipolar parent living in the Netherlands, using multiple sources of information (self-, parent, and teacher reports). METHOD: Problem behavior in 140 offspring (aged 12-21 years) of 86 bipolar parents was assessed with the Child Behavior Checklist (CBCL), the Teacher's Report Form (TRF), and the Youth Self-Report (YSR) between 1997 and 1999. All adolescents, bipolar parents, and their available spouses were interviewed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). RESULTS: Higher problem scores were found for 8 of the 11 CBCL scales for girls and 4 of the 11 CBCL scales for boys, compared with a Dutch normative sample, and 1 Young Adult Self-Report (YASR) scale for girls compared with an American normative sample. Lower problem scores were found on 4 YSR and 4 YASR scales for boys, 1 TRF scale for girls, and 1 TRF scale for boys. The prevalence of current DSM-IV diagnoses in the offspring was 29% and of life-time DSM-IV diagnoses, 44%. CONCLUSIONS: The prevalence of problem behavior and DSM-IV diagnoses found in our sample did not support the notion that the level of psychopathology in children aged 12 to 21 years of bipolar parents is highly elevated. This study, similar to prior studies, suffers from lack of information on the representativeness of the sample and a rather low response rate.

Bipolar disorder in children and adolecents: a clinical reality?

The appearance, the differential diagnosis and the prevalence of bipolar disorder in children and adolescents is discussed. Among adolescents bipolar disorder appears to have a similar prevalence in the US and The Netherlands. However, among children it is frequently diagnosed in the US and hardly in The Netherlands. It is concluded that bipolar disorder tends to start earlier in the US than in the Netherlands. It is hypothesized that this may be related to a higher use of stimulants and antidepressants by US children diagnosed as ADHD or depression, respectively.

Prevalence of psychopathology in children of bipolar parents.

The purpose of this study was to determine psychopathology in a large sample of adolescent children (N = 140) of parents (N = 86) with bipolar disorders, using multiple sources of information (child, parent, teacher). The main aims of the study were: 1) to compare parent, teacher and self reported problem behavior ratings of children of bipolar parents with those of children from the general population, and 2) to determine the prevalence of DSM-IV diagnoses in offspring of bipolar parents, and 3) to examine the possible association between gender of the bipolar parent and psychopathology among the offspring.