Family History of Psychiatric Illness Increases Risk in Offspring

bipolar disorder
bipolar disorder
A family history of illness in prior generations may be related to an earlier age at onset of bipolar disease.

Family history of psychiatric illness is associated with the incidence of multiple psychiatric illnesses in offspring, according to results published in Bipolar Disorders.

The study included outpatients with bipolar disorder (n=968). Participants completed a detailed questionnaire about family history of their parents, grandparents, and offspring regarding depression, bipolar disorder, alcohol abuse, substance abuse, suicide attempt, or other illness.

In total, 38.6% of the offspring had a psychiatric diagnosis or made a suicide attempt. Depression and other illnesses were the most commonly reported diagnoses, while alcohol abuse and suicide attempts were the least commonly reported.

The researchers found there was a multi-generational impact: depression in grandparents and/or great-grandparents increased the risk for depression in offspring from 12.6% to 41.4%. The type of illness that occurred 2 and 3 generations previously was almost always the same type of illness that emerged in the offspring. The risk for drug abuse in offspring increased to 25% if 2 generations were positive and 75% if 3 generations were positive for drug abuse.

These results indicate the need for more research on the genetic and epigenetic mechanisms for the multi-generational conveyance of illness vulnerability. In addition, public health measures should be taken to help prevent or slow transmission.

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“Family-focused therapy or other related therapies may be of particular importance as they target many of these different childhood syndromes,” the researchers wrote. “Also, multiple safe and well-tolerated pharmacological agents deserve further exploration for their effectiveness in early intervention in addition to the study of more traditional drugs used in adults such as lithium, mood- stabilizing anticonvulsants, and atypical antipsychotics.”


Post RM, Altshuler LL, Kupka R, et al. Multigenerational transmission of liability to psychiatric illness in offspring of parents with bipolar disorder [published online June 21, 2018]. Bipolar Disord. doi:10.1111/bdi.12668