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Bipolar disorder and parental psychopathology
Dan Sucksdorff1, Roshan Chudal, Auli Suominen
1Department of Child Psychiatry, Faculty of Medicine, Research Centre for Child Psychiatry, Institute of Clinical Medicine, University of Turku, Lemminkäisenkatu 3/Teutori (3rd floor), 20014, Turku, Finland, dansuc@utu.fi.
Insights
Parental bipolar disorder (BPD) and schizophrenia significantly increase offspring BPD risk. These associations persist even when parental diagnoses precede offspring birth, suggesting child-independent factors contribute to the increased risk of bipolar disorder.
Area of Science:
- Psychiatry
- Genetics
- Epidemiology
Background:
- Parental psychopathology is a known risk factor for offspring bipolar disorder (BPD).
- Previous studies have limitations in controlling for socio-economic status, maternal smoking, and parental diagnoses made before offspring birth.
- Understanding these familial links is crucial for early identification and intervention strategies.
Purpose of the Study:
- To investigate the association between parental psychiatric disorders and the risk of BPD in offspring.
- To examine associations for parental disorders diagnosed at any time and specifically those diagnosed before offspring birth.
- To control for potential confounding factors like parental education and maternal smoking.
Main Methods:
- A nested case-control study utilizing Finnish national registers.
- Inclusion of 1,861 cases of BPD in offspring (up to age 25) and 3,643 matched controls.
- Conditional logistic regression analysis, adjusting for covariates including parental age, education, and maternal smoking during pregnancy.
Main Results:
- Parental BPD showed strong associations with offspring BPD (OR maternal 5.2, paternal 8.1).
- Parental schizophrenia and related psychoses also significantly increased offspring BPD risk (OR maternal 3.1, paternal 4.5).
- Other parental affective and anxiety disorders were associated with increased offspring BPD risk, with significant findings for diagnoses made before offspring birth.
Conclusions:
- BPD in offspring is linked to a range of parental psychiatric disorders, notably parental BPD and schizophrenia.
- The observed associations are partly attributable to child-independent factors.
- Statistical adjustments for covariates minimally impacted the strength of these associations.
Purpose:
Few population-based studies have examined the association between parental psychopathology and bipolar disorder (BPD) in offspring. One limitation is lack of control for potential confounding by indicators of parental socio-economic status or maternal smoking during pregnancy. Furthermore, none of them included analyses restricted to parental diagnoses received prior to the birth of the offspring. Associations could not be affected by child-related factors affecting the parent in such analyses. This study explores associations between those parental psychiatric disorders diagnosed at any point of time as well as those diagnosed before offspring birth, and BPD in offspring.
Methods:
In this nested case-control study, we identified 1,861 cases, age up to 25 years, 3,643 matched controls, and their parents from Finnish national registers. The associations were examined using conditional logistic regression, calculating odds ratios (OR) and adjusting for region of birth, parental age and education and mother's smoking during pregnancy.
Results:
Anytime diagnosed parental disorders associating with BPD in offspring (95% confidence interval) were BPD [OR (maternal) 5.2 (2.52-10.62); OR (paternal) 8.1 (3.77-17.26)], schizophrenia and related psychoses [OR (maternal) 3.1 (1.69-5.84); OR (paternal) 4.5 (1.97-10.27)], other affective disorders [OR (maternal) 3.0 (2.08-4.21); OR (paternal) 3.0 (1.97-4.47)] and maternal anxiety disorders OR 2.6 (1.08-6.42). Statistically significant associations were also found for parental schizophrenia and related psychoses, and other affective disorders, diagnosed before offspring birth.
Conclusions:
BPD is associated with many parental psychiatric disorders, particularly BPD and schizophrenia and related psychoses. The associations must be partially due to child-independent factors. Covariate adjustments had only a minor impact on the associations.
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