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Dimensional psychopathology in preschool offspring of parents with bipolar disorder
Hagai Maoz1, Tina Goldstein, David A Axelson
1Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Insights
Preschool children of parents with bipolar disorder (BP) exhibit increased aggression, mood issues, sleep problems, and somatic complaints. Early interventions are crucial for these vulnerable children.
Area of Science:
- Child psychology
- Psychiatry
- Developmental psychopathology
Background:
- Bipolar disorder (BP) is a serious mental health condition.
- Children of parents with BP are at higher risk for psychopathology.
- Understanding early signs in offspring is crucial for timely intervention.
Purpose of the Study:
- To compare dimensional psychopathology in preschool children of parents with bipolar disorder (BP) versus controls.
- To identify specific behavioral and emotional differences in offspring.
- To inform early intervention strategies.
Main Methods:
- Parental reports on psychopathology were collected for 122 preschool children of parents with BP and 102 control children.
- Standardized assessments included the Child Behavior Checklist (CBCL), CBCL-Dysregulation Profile (CBCL-DP), Early Childhood Inventory (ECI-4), and Emotionality Activity Sociability (EAS) survey.
- Teacher reports (TRF) were also analyzed for a subset of children.
Main Results:
- Offspring of parents with BP showed higher scores in aggression, mood dysregulation, sleep disturbances, and somatic complaints on multiple measures.
- These differences persisted even after excluding children with ADHD or ODD.
- BP-II offspring exhibited more severe symptoms than BP-I offspring in certain areas.
Conclusions:
- Preschool children of parents with BP demonstrate significantly higher levels of aggression, mood dysregulation, sleep disturbances, and somatic complaints.
- These findings are independent of parental Axis-I psychopathology and other factors.
- Targeted interventions are recommended to address these emerging symptoms in high-risk children.
Background:
The purpose of this study is to compare the dimensional psychopathology, as ascertained by parental report, in preschool offspring of parents with bipolar disorder (BP) and offspring of community control parents.
Methods:
122 preschool offspring (mean age 3.3 years) of 84 parents with BP, with 102 offspring of 65 control parents (36 healthy, 29 with non-BP psychopathology), were evaluated using the Child Behavior Checklist (CBCL), the CBCL-Dysregulation Profile (CBCL-DP), the Early Childhood Inventory (ECI-4), and the Emotionality Activity Sociability (EAS) survey. Teachers' Report Forms (TRF) were available for 51 preschoolers.
Results:
After adjusting for confounders, offspring of parents with BP showed higher scores in the CBCL total, externalizing, somatic, sleep, aggressive, and CBCL-DP subscales; the ECI-4 sleep problem scale; and the EAS total and emotionality scale. The proportion of offspring with CBCL T-scores ≥ 2 SD above the norm was significantly higher on most CBCL subscales and the CBCL-DP in offspring of parents with BP compared to offspring of controls even after excluding offspring with attention deficit hyperactivity disorder and/or oppositional defiant disorder. Compared to offspring of parents with BP-I, offspring of parents with BP-II showed significantly higher scores in total and most CBCL subscales, the ECI-4 anxiety and sleep scales and the EAS emotionality scale. For both groups of parents, there were significant correlations between CBCL and TRF scores (r = .32-.38, p-values ≤.02).
Conclusions:
Independent of categorical axis-I psychopathology and other demographic or clinical factors in both biological parents, preschool offspring of parents with BP have significantly greater aggression, mood dysregulation, sleep disturbances, and somatic complaints compared to offspring of control parents. Interventions to target these symptoms are warranted.
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