Children of individuals with major depressive disorder (MDD), conduct disorder, and drug use disorders may have a higher risk of hypomanic episodes and children of individuals with separation anxiety disorder may have a higher risk of major depressive disorder, found a new study published in the Journal of Child Psychology and Psychiatry.

While researchers had evidence of bipolar disorder (BPD) and major depressive disorder (MDD) emerging in childhood and adolescence, they wanted to know more about the subtypes of mood disorders in the children of parents with both major subtypes and controls. This information may help them better understand precursors to these conditions.

The researchers used data from the Lausanne–Geneva high-risk study on mood disorders, which included children (449 total) of patients with bipolar-I, bipolar-II, schizoaffective bipolar disorder, MDD, alcohol or heroin dependence, and medical controls recruited between 1996 and 2004. The researchers also used information from the Diagnostic Interview for Genetic Studies, family history reports, and interviews conducted by psychologists.

Among other data, the researchers found that 18 children met criteria for at least one manic episode, 28 for a hypomanic episode (without a manic episode) and 202 children met the criteria for MDD.


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Major depressive episodes, conduct disorder, and drug use disorders were significantly associated with the onset of hypomanic episodes, with a more than 2 to 4 times higher risk. Major depressive episodes were reported by more than 70% of the children. Only 13% of those developed hypomanic episodes.

“Our findings suggest distinct pathways to the development of bipolar and unipolar mood disorders. Offspring of parents with BPD who exhibit MDE [Major Depressive Episode], CD [Conduct Disorder], or DUD [Drug Use Disorder] should be particularly closely monitored and may benefit from early interventions to prevent conversion to BPD,” the researchers concluded. “Similarly, early screening and treatment of children with anxiety disorders could reduce their risk of developing MDD.”

Concerning limitations, the researchers did not have enough participants to evaluate associations between children with hypomanic episodes and their parents. Collection of information was retrospective and less severe episodes were not documented.

Reference

Rudaz D, Vandeleur CL, Gholam M, et al. Psychopathological precursors of the onset of mood disorders in children of parents with and without mood disorders: results of a 13-year prospective cohort high-risk study [published online August 25, 2020]. J Child Psychol Psychiatry. 2020;10.1111/jcpp.13307. doi: 10.1111/jcpp.13307