Affective lability in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia

Abstract

Affective lability, defined as the propensity to experience excessive and unpredictable changes in mood, has been proposed as a potential transdiagnostic predictor of major mood and psychotic disorders. A parental diagnosis of bipolar disorder has been associated with increased affective lability in offspring. However, the association between affective lability and family history of other mood and psychotic disorders has not been examined. We measured affective lability using the self- and parent-reported Children’s Affective Lability Scale in a cohort of 320 youth aged 6–17 years, including 137 offspring of a parent with major depressive disorder, 68 offspring of a parent with bipolar disorder, 24 offspring of a parent with schizophrenia, and 91 offspring of control parents. We tested differences in affective lability between groups using mixed-effects linear regression. Offspring of a parent with major depressive disorder (β = 0.46, 95% CI 0.17–0.76, p = 0.002) or bipolar disorder (β = 0.47, 95% CI 0.12–0.81, p = 0.008) had significantly higher affective lability scores than control offspring. Affective lability did not differ significantly between offspring of a parent with schizophrenia and offspring of control parents. Our results suggest that elevated affective lability during childhood is a marker of familial risk for mood disorders.

This is a preview of subscription content, log in to check access.

Fig. 1

References

  1. 1.

    Vos T, Allen C, Arora M et al (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the global burden of disease study 2015. Lancet 388:1545–1602

    Article  Google Scholar 

  2. 2.

    Smith K (2011) Trillion-dollar brain drain. Nature 478:15

    CAS  Article  Google Scholar 

  3. 3.

    Zwicker A, Denovan-Wright EM, Uher R (2018) Gene–environment interplay in the etiology of psychosis. Psychol Med 48:1925–1936

    Article  Google Scholar 

  4. 4.

    Uher R, Zwicker A (2017) Etiology in psychiatry: embracing the reality of poly-gene-environmental causation of mental illness. World Psychiatry 16:121–129

    Article  Google Scholar 

  5. 5.

    Forstner AJ, Hecker J, Hofmann A et al (2017) Identification of shared risk loci and pathways for bipolar disorder and schizophrenia. PLoS One 12:e0171595

    Article  Google Scholar 

  6. 6.

    Lee SH, Ripke S, Neale BM et al (2013) Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs. Nat Genet 45:984–994

    CAS  Article  Google Scholar 

  7. 7.

    Selzam S, Coleman JRI, Caspi A, Moffitt TE, Plomin R (2018) A polygenic p factor for major psychiatric disorders. Transl Psychiatry 8:205

    Article  Google Scholar 

  8. 8.

    Gandal MJ, Haney JR, Parikshak NN et al (2018) Shared molecular neuropathology across major psychiatric disorders parallels polygenic overlap. Science 359:693–697

    CAS  Article  Google Scholar 

  9. 9.

    Caspi A, Houts RM, Belsky DW et al (2014) The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clin Psychol Sci 2:119–137

    Article  Google Scholar 

  10. 10.

    Gottesman II, Laursen TM, Bertelsen A, Mortensen PB (2010) Severe mental disorders in offspring with 2 psychiatrically ill parents. Arch Gen Psychiatry 67:252

    Article  Google Scholar 

  11. 11.

    Meier SM, Pavlova B, Dalsgaard S et al (2018) Attention-deficit hyperactivity disorder and anxiety disorders as precursors of bipolar disorder onset in adulthood. Br J Psychiatry 213(3):555–560

    Article  Google Scholar 

  12. 12.

    Broome MR, Saunders KEA, Harrison PJ, Marwaha S (2015) Mood instability: significance, definition and measurement. Br J Psychiatry 207:283–285

    CAS  Article  Google Scholar 

  13. 13.

    Sheppes G, Suri G, Gross JJ (2015) Emotion regulation and psychopathology. Annu Rev Clin Psychol 11:379–405

    Article  Google Scholar 

  14. 14.

    Kochman FJ, Hantouche EG, Ferrari P, Lancrenon S, Bayart D, Akiskal HS (2005) Cyclothymic temperament as a prospective predictor of bipolarity and suicidality in children and adolescents with major depressive disorder. J Affect Disord 85:181–189

    CAS  Article  Google Scholar 

  15. 15.

    Gerson AC, Gerring JP, Freund L et al (1996) The children’s affective lability scale: a psychometric evaluation of reliability. Psychiatry Res 65:189–198

    CAS  Article  Google Scholar 

  16. 16.

    Reich DB, Zanarini MC, Fitzmaurice G (2012) Affective lability in bipolar disorder and borderline personality disorder. Compr Psychiatry 53:230–237

    Article  Google Scholar 

  17. 17.

    Birmaher B, Goldstein BI, Axelson DA et al (2013) Mood lability among offspring of parents with bipolar disorder and community controls. Bipolar Disord 15:253–263

    Article  Google Scholar 

  18. 18.

    Maoz H, Goldstein T, Axelson DA et al (2014) Dimensional psychopathology in preschool offspring of parents with bipolar disorder. J Child Psychol Psychiatry 55:144–153

    Article  Google Scholar 

  19. 19.

    Hafeman DM, Merranko J, Axelson D et al (2016) Toward the definition of a bipolar prodrome: dimensional predictors of bipolar spectrum disorders in at-risk youths. Am J Psychiatry 173:695–704

    Article  Google Scholar 

  20. 20.

    Thompson RJ, Berenbaum H, Bredemeier K (2011) Cross-sectional and longitudinal relations between affective instability and depression. J Affect Disord 130:53–59

    Article  Google Scholar 

  21. 21.

    Rice F, Sellers R, Hammerton G et al (2017) Antecedents of new-onset major depressive disorder in children and adolescents at high familial risk. JAMA Psychiatry 74:153

    Article  Google Scholar 

  22. 22.

    Goghari VM (2017) Personality dimensions in schizophrenia: a family study. Psychiatry Res 251:162–167

    Article  Google Scholar 

  23. 23.

    Marwaha S, Broome MR, Bebbington PE, Kuipers E, Freeman D (2014) Mood instability and psychosis: analyses of British national survey data. Schizophr Bull 40:269–277

    Article  Google Scholar 

  24. 24.

    Rasic D, Hajek T, Alda M, Uher R (2014) Risk of mental illness in offspring of parents with schizophrenia, bipolar disorder, and major depressive disorder: a meta-analysis of family high-risk studies. Schizophr Bull 40:28–38

    Article  Google Scholar 

  25. 25.

    Uher R, Cumby J, MacKenzie LE et al (2014) A familial risk enriched cohort as a platform for testing early interventions to prevent severe mental illness. BMC Psychiatry 14:344

    Article  Google Scholar 

  26. 26.

    Kaufman J, Birmaher B, Brent D et al (1997) Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–988

    CAS  Article  Google Scholar 

  27. 27.

    Wechsler D (1999) Wechsler abbreviated scale of intelligence. Psychological Corporation, San Antonio

    Google Scholar 

  28. 28.

    Bates D, Mächler M, Bolker B, Walker S (2015) Fitting linear mixed-effects models using lme4. J Stat Softw 67:1–48

    Article  Google Scholar 

  29. 29.

    Propper L, Ortiz A, Slaney C et al (2015) Early-onset and very-early-onset bipolar disorder: distinct or similar clinical conditions? Bipolar Disord 17:814–820

    Article  Google Scholar 

  30. 30.

    Althoff RR, Crehan ET, He J-P, Burstein M, Hudziak JJ, Merikangas KR (2016) Disruptive mood dysregulation disorder at ages 13–18: results from the national comorbidity survey—adolescent supplement. J Child Adolesc Psychopharmacol 26:107–113

    Article  Google Scholar 

  31. 31.

    Carlson GA (2016) Disruptive mood dysregulation disorder: where did it come from and where is it going. J Child Adolesc Psychopharmacol. 26:90–93

    Article  Google Scholar 

  32. 32.

    Propper L, Cumby J, Patterson VC et al (2017) Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder. Br J Psychiatry 210:408–412

    Article  Google Scholar 

  33. 33.

    Power RA, Kyaga S, Uher R et al (2013) Fecundity of patients with schizophrenia, autism, bipolar disorder, depression, anorexia nervosa, or substance abuse vs their unaffected siblings. JAMA Psychiatry 70:22

    Article  Google Scholar 

Download references

Acknowledgements

The work leading to this publication has been supported by funding from the Canada Research Chairs Program (Award Number 231397), the Canadian Institutes of Health Research (Grant reference numbers 124976, 142738 and 148394), the Brain & Behavior Research Foundation (NARSAD) Independent Investigator Grant 24684, Nova Scotia Health Research Foundation (Grants 275319, 1716 and 353892) and the Dalhousie Medical Research Foundation. Ms. Zwicker has been supported by the Lindsay Family Graduate Studentship. Mr. Drobinin was supported by the CIHR Doctoral Award (157975).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Rudolf Uher.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 15 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zwicker, A., Drobinin, V., MacKenzie, L.E. et al. Affective lability in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. Eur Child Adolesc Psychiatry 29, 445–451 (2020). https://doi.org/10.1007/s00787-019-01355-z

Download citation

Keywords

  • Severe mental illness
  • Mood lability
  • Cohort study
  • High-risk offspring
  • Developmental psychopathology
  • Antecedent