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Family environment of children and adolescents with bipolar parents
K D Chang1, C Blasey, T A Ketter
1Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, CA 94305-5540, USA. kchang88@stanford.edu.
Insights
Families with a parent diagnosed with bipolar disorder (BD) exhibit less cohesion and organization, with increased conflict. However, the family environment alone does not solely determine psychopathology in children at high risk for BD.
Area of Science:
- Child and Adolescent Psychiatry
- Family Psychology
- Genetic Psychiatry
Background:
- The role of family environment in childhood bipolar disorder (BD) development remains unclear.
- Understanding familial factors is crucial for identifying children at high risk for BD.
Purpose of the Study:
- To characterize the family environment of children at high risk for developing BD.
- To investigate the contribution of family dynamics to childhood BD.
Main Methods:
- Collected demographic data and Family Environment Scale (FES) ratings from 36 families with children (6-18 years) and at least one parent with BD.
- Utilized semistructured interviews for prior psychiatric diagnoses of the cohort.
Main Results:
- Parents in high-risk families rated significantly lower on FES Cohesion and Organization, and higher on Conflict compared to normative data.
- No significant differences in FES scores were found between families with one or two parents with mood disorders.
- FES scores did not significantly differ for children with or without Axis I disorders or BD.
Conclusions:
- Families with a parent with BD show distinct environmental characteristics: reduced cohesion and organization, and increased conflict.
- The family environment alone does not appear to solely determine psychopathology in children at risk for BD.
- Childhood psychopathology does not appear to solely determine the family environment in these high-risk families.
Objectives:
The effect of family environment on the development of bipolar disorder (BD) in children is not known. We sought to characterize families with children at high risk for developing BD in order to better understand the contributions of family environment to the development of childhood BD.
Methods:
We collected demographic data and parental ratings on the Family Environment Scale (FES) for 56 children (aged 6-18 years) from 36 families with at least one biological parent with BD. The cohort had previously been psychiatrically diagnosed according to semistructured interviews.
Results:
Statistical comparisons with normative data indicated that parents' ratings were significantly lower on the FES Cohesion and Organization scales and were significantly higher on the FES Conflict scale. Multivariate analyses of variance indicated that families with both parents having a mood disorder had no significantly different FES scores than families with only one parent with a mood disorder (BD). Diagnostic data indicated that while 54% of the children in the sample had an Axis I disorder and 14% had BD, FES scores did not differ significantly for subjects with or without an Axis I disorder, or with or without BD.
Conclusions:
Families with a bipolar parent differ from the average family in having less cohesion and organization, and more conflict. Despite this difference, it does not appear that the environment alone of families with a bipolar parent determines the outcome of psychopathology in the children, or that the psychopathology of the children determines the family environment.
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