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Controlled, blindly rated, direct-interview family study of a prepubertal and early-adolescent bipolar I disorder phenotype: morbid risk, age at onset, and comorbidity.
Arch Gen Psychiatry. 2006 Oct; 63(10):1130-8.AG

Abstract

CONTEXT

A key question is whether a prepubertal and early-adolescent bipolar I disorder phenotype (PEA-BP-I) is the same illness as adult BP-I. This question arises because of the greater severity, longer current episode duration, preponderance of mania, and high rates of ultradian rapid cycling and comorbid attention-deficit/hyperactivity disorder (ADHD) in PEA-BP-I.

OBJECTIVES

To examine morbid risk (MR) of BP-I in first-degree relatives of PEA-BP-I, ADHD, and healthy control probands, as well as imprinting, sibling recurrence risk, and anticipation.

DESIGN

Controlled, blind direct interview. There were no family psychopathology exclusions for any proband group.

SETTING

University medical school research unit.

PARTICIPANTS

First-degree relatives 6 years and older (n = 690) of 219 probands (95 with PEA-BP-I, 47 with ADHD, and 77 healthy controls). The PEA-BP-I and ADHD probands were obtained by consecutive new case ascertainment, and healthy controls were from a random survey; proband diagnoses were validated via 4-year prospective follow-up. The PEA-BP-I probands had a mean +/- SD age of 10.8 +/- 2.6 years. Main Outcome Measure Morbid risk.

RESULTS

The MR of BP-I was higher in relatives of PEA-BP-I probands compared with ADHD or healthy controls (P<.001 for both); the MR in relatives of ADHD and healthy controls was similar. The MR of BP-I in relatives with ADHD was higher (P<.001) and age at onset of BP-I was younger in parents with ADHD than in those without (P<.001). The MR of BP-I in relatives with oppositional, conduct, or antisocial disorders was higher than in those without (P<.001). Anticipation was evidenced by a younger age at onset of BP-I in probands than in their parents (P<.001). No imprinting was found.

CONCLUSIONS

Findings support that PEA-BP-I and adult BP-I are the same diathesis, 7 to 8x greater familiality in child vs adult BP-I, and family study validation of PEA-BP-I, including its differentiation from ADHD.

Authors+Show Affiliations

Department of Psychiatry, Washington University in St Louis, St Louis, MO 63110-1093, USA. gellerb@medicine.wustl.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17015815

Citation

Geller, Barbara, et al. "Controlled, Blindly Rated, Direct-interview Family Study of a Prepubertal and Early-adolescent Bipolar I Disorder Phenotype: Morbid Risk, Age at Onset, and Comorbidity." Archives of General Psychiatry, vol. 63, no. 10, 2006, pp. 1130-8.
Geller B, Tillman R, Bolhofner K, et al. Controlled, blindly rated, direct-interview family study of a prepubertal and early-adolescent bipolar I disorder phenotype: morbid risk, age at onset, and comorbidity. Arch Gen Psychiatry. 2006;63(10):1130-8.
Geller, B., Tillman, R., Bolhofner, K., Zimerman, B., Strauss, N. A., & Kaufmann, P. (2006). Controlled, blindly rated, direct-interview family study of a prepubertal and early-adolescent bipolar I disorder phenotype: morbid risk, age at onset, and comorbidity. Archives of General Psychiatry, 63(10), 1130-8.
Geller B, et al. Controlled, Blindly Rated, Direct-interview Family Study of a Prepubertal and Early-adolescent Bipolar I Disorder Phenotype: Morbid Risk, Age at Onset, and Comorbidity. Arch Gen Psychiatry. 2006;63(10):1130-8. PubMed PMID: 17015815.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Controlled, blindly rated, direct-interview family study of a prepubertal and early-adolescent bipolar I disorder phenotype: morbid risk, age at onset, and comorbidity. AU - Geller,Barbara, AU - Tillman,Rebecca, AU - Bolhofner,Kristine, AU - Zimerman,Betsy, AU - Strauss,Nancy A, AU - Kaufmann,Patricia, PY - 2006/10/4/pubmed PY - 2006/11/7/medline PY - 2006/10/4/entrez SP - 1130 EP - 8 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 63 IS - 10 N2 - CONTEXT: A key question is whether a prepubertal and early-adolescent bipolar I disorder phenotype (PEA-BP-I) is the same illness as adult BP-I. This question arises because of the greater severity, longer current episode duration, preponderance of mania, and high rates of ultradian rapid cycling and comorbid attention-deficit/hyperactivity disorder (ADHD) in PEA-BP-I. OBJECTIVES: To examine morbid risk (MR) of BP-I in first-degree relatives of PEA-BP-I, ADHD, and healthy control probands, as well as imprinting, sibling recurrence risk, and anticipation. DESIGN: Controlled, blind direct interview. There were no family psychopathology exclusions for any proband group. SETTING: University medical school research unit. PARTICIPANTS: First-degree relatives 6 years and older (n = 690) of 219 probands (95 with PEA-BP-I, 47 with ADHD, and 77 healthy controls). The PEA-BP-I and ADHD probands were obtained by consecutive new case ascertainment, and healthy controls were from a random survey; proband diagnoses were validated via 4-year prospective follow-up. The PEA-BP-I probands had a mean +/- SD age of 10.8 +/- 2.6 years. Main Outcome Measure Morbid risk. RESULTS: The MR of BP-I was higher in relatives of PEA-BP-I probands compared with ADHD or healthy controls (P<.001 for both); the MR in relatives of ADHD and healthy controls was similar. The MR of BP-I in relatives with ADHD was higher (P<.001) and age at onset of BP-I was younger in parents with ADHD than in those without (P<.001). The MR of BP-I in relatives with oppositional, conduct, or antisocial disorders was higher than in those without (P<.001). Anticipation was evidenced by a younger age at onset of BP-I in probands than in their parents (P<.001). No imprinting was found. CONCLUSIONS: Findings support that PEA-BP-I and adult BP-I are the same diathesis, 7 to 8x greater familiality in child vs adult BP-I, and family study validation of PEA-BP-I, including its differentiation from ADHD. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/17015815/Controlled_blindly_rated_direct_interview_family_study_of_a_prepubertal_and_early_adolescent_bipolar_I_disorder_phenotype:_morbid_risk_age_at_onset_and_comorbidity_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archpsyc.63.10.1130 DB - PRIME DP - Unbound Medicine ER -