Clinical staging model in offspring of parents with bipolar disorder: a systematic review

Area of Science:

• Psychiatry
• Developmental Psychology
• Genetics

Background:

• Offspring of parents with bipolar disorder (OPBD) represent a high-risk group for developing psychiatric disorders.
• Understanding the developmental trajectory of these risks is crucial for early intervention.
• Developmental psychopathology and clinical stage modeling offer frameworks for this understanding.

Purpose of the Study:

• To systematically review the literature on psychiatric risks in OPBD.
• To examine the utility of clinical stage modeling for identifying precursor disorders to bipolar disorder (BD) in OPBD.
• To elucidate the developmental pathways of psychiatric risk in this population.

Main Methods:

• Systematic literature search across EMBASE, PsychINFO, and Medline databases.
• Inclusion of studies reporting diagnostic outcomes for offspring of parents with BD.
• Analysis of 26 studies representing 21 distinct cohorts.

Main Results:

• OPBD are at high risk for mood and non-mood disorders across childhood, adolescence, and young adulthood.
• A developmental trajectory was observed: non-mood disorders in childhood, non-bipolar mood disorders in early adolescence, progressing to mania/hypomania later.
• Childhood anxiety disorders and recurrent substance use disorder in late adolescence/early adulthood are significant risk factors for BD onset.

Conclusions:

• Evidence supports a developmental psychopathology trajectory of precursor risks for BD in OPBD.
• Clinical stage modeling is a valuable conceptual framework for understanding developmental risk in OPBD.
• This framework can inform the development of early and individualized intervention strategies for OPBD.