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A developmental approach to dimensional expression of psychopathology in child and adolescent offspring of parents with bipolar disorder

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Abstract

The aim of this is to describe psychopathology, functioning and symptom dimensions accounting for subthreshold manifestations and developmental status in child and adolescent offspring of parents with bipolar disorder (“high-risk offspring”). The study population comprised 90 high-risk offspring (HR-offspring) and 107 offspring of community control parents (CC-offspring). Direct clinical observations and parental and offspring reports based on selected standardized clinical scales were used to assess offspring threshold and subthreshold diagnoses, symptoms and functioning. All outcomes were compared between the whole HR-offspring and CC-offspring samples and then by developmental status. After controlling for potential confounders, HR-offspring showed significantly poorer adjustment for childhood (r = 0.18, p = 0.014) and adolescence (r = 0.21, p = 0.048) than CC-offspring, as well as more emotional problems (r = 0.24, p = 0.001) and higher depression scores (r = 0.16, p = 0.021). As for differences in lifetime categorical diagnoses (threshold and subthreshold) between HR-offspring and CC-offspring, the prevalence of disruptive disorders was higher in pre-pubertal HR-offspring (OR 12.78 [1.45–112.42]), while prevalence of mood disorders was higher in post-pubertal HR-offspring (OR 3.39 [1.14–10.06]). Post-pubertal HR-offspring presented more prodromal (r = 0.40, p = 0.001), negative (r = 0.38, p = 0.002), manic (r = 0.22, p = 0.035) and depressive (r = 0.23, p = 0.015) symptoms than pre-pubertal HR-offspring, as well as more peer relationship problems (r = 0.31, p = 0.004), poorer childhood adjustment (r = 0.22, p = 0.044) and worse current psychosocial functioning (r = 0.27, p = 0.04). Externalizing psychopathology is more prevalent in pre-pubertal HR-offspring, while depressive and prodromal symptoms leading to functional impairment are more prominent in post-pubertal HR-offspring. Developmental approaches and dimensional measures may be useful for identifying children at high risk of developing bipolar disorder and help guide specific preventive strategies.

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Acknowledgements/Funding sources

This work was supported by the Spanish Ministry of Economy and Competitiveness, Instituto de Salud Carlos III (PI070066; PI07/0853; PI1100683, PI11/02283) and co-financed by the European Regional Development Funds from the European Commission, “A way of making Europe,” CIBERSAM and Fundació La Marató de TV3 (091630, 091631).

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Authors and Affiliations

  1. Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza 43, 28009, Madrid, Spain

    María Goretti Morón-Nozaleda, Covadonga M. Díaz-Caneja, Elisa Rodríguez-Toscano, Celso Arango, Ana Espliego, Carmen Moreno & Dolores Moreno

  2. Department of Psychiatry and Clinical Psychology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain

    María Goretti Morón-Nozaleda

  3. Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain

    Josefina Castro-Fornieles, Elena de la Serna, Vanessa Sanchez-Gistau, Soledad Romero & Immaculada Baeza

  4. Institut d’Investigacións Biomèdiques d’August Pi i Sunyer, IDIBAPS, Barcelona, Spain

    Josefina Castro-Fornieles, Immaculada Baeza & Gisela Sugranyes

  5. Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain

    Josefina Castro-Fornieles, Elena de la Serna, Soledad Romero, Immaculada Baeza & Gisela Sugranyes

  6. Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain

    Josefina Castro-Fornieles

  7. Early Psychosis Program and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Tarragona, Spain

    Vanessa Sanchez-Gistau

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  1. María Goretti Morón-Nozaleda
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  2. Covadonga M. Díaz-Caneja
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  3. Elisa Rodríguez-Toscano
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  5. Josefina Castro-Fornieles
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  6. Elena de la Serna
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  7. Ana Espliego
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  8. Vanessa Sanchez-Gistau
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  11. Gisela Sugranyes
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  12. Carmen Moreno
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  13. Dolores Moreno
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Correspondence to María Goretti Morón-Nozaleda.

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Conflict of interest/disclosures

María Goretti Morón-Nozaleda received a grant awarded from Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness (ISCIII) and honoraria from Janssen Cilag and Shire. Covadonga M. Díaz-Caneja obtained grants awarded from ISCIII, and Fundación Alicia Koplowitz (FAK). Elisa Rodriguez-Toscano received grant awarded from ISCIII. Celso Arango obtained consultancy/honoraria/grants from Abbot, AMGEN, AstraZeneca, Bristol-Myers Squibb, Caja Navarra, CIBERSAM, FAK, Forum, ISCIII, Janssen Cilag, Lundbeck, Merck, Ministerio de Ciencia e Innovación, Ministerio de Sanidad, Ministerio de Economía y Competitividad, Mutua Madrileña, Otsuka, Pfizer, Roche, Servier, Shire, Schering Plough and Takeda. Vanessa Sánchez-Gistau received honoraria from Otsuka. Inmaculada Baeza: honoraria from Otsuka and Janssen, and grants from FAK and ISCIII. Gisella Sugranyes obtained honoraria from Adamed. Carmen Moreno received consultancy/honoraria from Janssen, Servier and Lundbeck and grants or research support from the European Union Funds, CIBERSAM, ISCIII and FAK. Dolores Moreno obtained consultancy/honoraria from Janssen Cilag, Shire and Rovi. The rest of authors declare no conflicts of interest.

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Carmen Moreno and Dolores Moreno are joint senior authors.

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Morón-Nozaleda, M.G., Díaz-Caneja, C.M., Rodríguez-Toscano, E. et al. A developmental approach to dimensional expression of psychopathology in child and adolescent offspring of parents with bipolar disorder. Eur Child Adolesc Psychiatry 26, 1165–1175 (2017). https://doi.org/10.1007/s00787-017-0965-3

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