Parental Bipolar Disorder May Affect Presentation of Pediatric Bipolar Disorder

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Children with pediatric bipolar disorder who had a parent with bipolar disorder showed a greater prevalence of comorbid ADHD compared with children with the same diagnosis but healthy parents.

Youth with pediatric bipolar disorder were more likely to have comorbid attention-deficit/hyperactivity disorder (ADHD) if they had a parent with bipolar disorder, according to study data published in Psychiatry Research.

Investigators conducted a cross-sectional study of 61 youths (6-17 years) with pediatric bipolar disorder, recruited from an outpatient program at a hospital in Brazil. Both patients and their caregivers were administered the St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia. Clinical and sociodemographic factors, including family history of psychiatric disorders, were captured by self-report. Multivariable analyses were used to calculate the odds ratios (ORs) for ADHD, rapid cycling, and lifetime psychosis among patients with and without a parent with bipolar disorder.

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Among 61 participants with pediatric bipolar disorder, 27 (44.3%) had a parent with bipolar disorder and 34 (55.7%) were offspring of parents without bipolar disorder. No significant between-group differences existed for gender, age, ethnicity, intelligence quotient, or type of bipolar diagnosis. Offspring of parents with bipolar disorder were significantly more likely to have ADHD compared with offspring of controls (P =.02). In addition, children of a parent with bipolar disorder experienced significantly earlier symptom onset compared with children of controls (P =.01). Multivariable analyses confirmed a significantly higher odds of ADHD comorbidity among offspring of patients compared with controls (OR, 3.5; 95% CI, 1.13-10.83). Children of individuals with bipolar disorder had an OR of 2.23 (95% CI, 0.78-6.4) for rapid cycling course of illness compared with children of controls. Offspring of a parent with bipolar disorder did not show increased rates of psychosis.

These data suggest that patients with pediatric bipolar disorder who have a parent with bipolar disorder experience a distinct endophenotype of the disorder. However, small sample size and cross-sectional study design limit the strength of these conclusions. A longitudinal study with a larger patient cohort is necessary to examine the differential presentation of pediatric bipolar disorder among children with and without affected parents.

Disclosure: One study author declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Ramos BR, Librenza-Garcia D, Zortea F, et al. Clinical differences between patients with pediatric bipolar disorder with and without a parental history of bipolar disorder. Psychiatry Res. 2019;280:112501.