A Longitudinal Study of Psychiatric Disorders in Offspring of Parents With Bipolar Disorder From Preschool to Adolescence.
A Longitudinal Study of Psychiatric Disorders in Offspring of Parents With Bipolar Disorder From Preschool to Adolescence.
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DOI：
10.1016/j.jaac.2021.02.023
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发表时间：
2021-11
影响因子：
13.3
通讯作者：
Goldstein T
中科院分区：
文献类型：
--
作者：
Birmaher B;Merranko J;Hafeman D;Goldstein BI;Diler R;Levenson JC;Monk K;Iyengar S;Hickey MB;Sakolsky D;Axelson D;Goldstein T
比较患有双相情感障碍(BD)父母的学龄前儿童和社区对照儿童的精神病理学，特别是BD的患病率。研究对象为BD-I/II双亲子女116人，对照组98人(其中53人为非BD精神病患者父母，45人为健康父母)，年龄2-5岁，平均随访9.6年(平均：2-5：1.6次；5岁以后：4次)(平均摄食/末次随访年龄：3.8/13.4，保留率：98%)。参与者使用标准化的仪器进行评估，对父母的诊断视而不见。在调整混杂因素后，BD父母的子女仅在2-5岁期间表现出比其他两组更多的注意力缺陷/多动障碍(ADHD)。5岁以后，BD父母的子女与非BD精神病父母的子女没有什么不同，但他们比健康父母的子女有更多的焦虑、ADHD和行为问题。仅有BD父母的子女发生BD-I/II：3.4%(n=4)和BD-NOS11.2%(n=13)，平均发病年龄分别为11.4岁和7.4岁。大约70%患有BD的后代在BD之前就有非BD疾病。只有在6岁前确诊的ADHD和早发的父母BD与BD风险显著相关。BD父母的子女大多没有发生BD，但他们是BD的高危人群，尤其是那些患有学龄前ADHD和早发性父母BD的人。BD症状在学龄前几年很少见，在整个学龄期都在增加，主要以BD-NOS的形式出现，这是一种预后较差的疾病，发生BD-I/II的风险很高。有必要制定早期干预措施，以延迟或最好是防止其发病。
To compare the prevalence of psychopathology, particularly bipolar disorder (BD), between preschool offspring of parents with BD and community controls. 116 offspring of BD-I/II parents and 98 controls (53 parents with non-BD psychopathology and 45 healthy parents) were recruited at ages 2–5 years and followed on average 9.6 years (on average: 2–5:1.6 times; after age 5:4 times) (average ages at intake/last follow-up: 3.8/13.4, retention:98%). Participants were evaluated with standardized instruments blind to parental diagnoses. After adjusting for confounders, offspring of BD parents only showed more attention-deficit/hyperactivity disorder (ADHD) during ages 2–5 than the other two groups. After age 5, offspring of BD parents did not differ from offspring of parents with non-BD psychopathology, but they had more anxiety, ADHD, and behavior problems than offspring of healthy parents. Only offspring of BD parents developed BD-I/II: 3.4% (n=4) and BD-Not-Otherwise-Specified (BD-NOS):11.2% (n=13), with mean onset ages 11.4 and 7.4, respectively. About 70% of offspring with BD had non-BD disorders before BD. Only ADHD, diagnosed before age 6, and early onset parental BD were significantly associated with BD risk. Most offspring of BD parents did not develop BD, but they were at specific high risk to develop BD, particularly those with preschool ADHD and early onset parental BD. BD symptoms were scarce during the preschool years and increased throughout the school-age, mainly in the form of BD-NOS, a disorder that conveys poor prognosis and high risk to develop BD-I/II. Developing early interventions to delay or, ideally, prevent its onset are warranted.