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Childhood anxiety: an early predictor of mood disorders in offspring of bipolar parents.
J Affect Disord. 2013 Sep 05; 150(2):363-9.JA

Abstract

BACKGROUND

Anxiety disorders are common among the offspring of parents with bipolar disorder (BD). This study investigated the nature of the association between anxiety disorders and mood disorders in a prospectively studied high-risk cohort.

METHODS

High-risk offspring were identified from families in which one parent had confirmed BD based on SADS-L interviews and best estimate diagnostic procedures. All agreeable offspring aged 8-25 years were enrolled in a longitudinal study involving repeated KSADS-PL format clinical assessments. Control (C) offspring from families in which neither parent met lifetime criteria for a psychiatric disorder were similarly assessed. All DSM-IV diagnoses in the offspring were confirmed on blind consensus review. Cumulative incidence and adjusted Cox Proportional Hazards models were used to calculate the risk of anxiety disorders and the predictive association with mood disorders.

RESULTS

The cumulative incidence of anxiety disorders was higher (23.40% vs. 10.42%; HR=2.136; p=.0382) and occurred earlier (9.79 vs. 14.84 years; p=.0125) in high-risk compared to C offspring. In high-risk offspring generalized anxiety disorders (GAD) followed by social phobia were the most incident anxiety subtypes; while high emotionality (HR 1.111; p=.0096) and shyness (HR 1.144; p=.0053) increased the risk of anxiety disorders. Anxiety disorders increased the adjusted risk of mood disorders (HR 2.166; p=.0004), on average 8.49 years later (SD 5.97).

LIMITATIONS

The cumulative incidence of BD is relatively low, as the cohort is still in the period of risk.

CONCLUSIONS

Findings highlight the need for longitudinal surveillance of symptomatic high-risk children and suggest anxiety disorders are an important early intervention target.

Authors+Show Affiliations

Hotchkiss Brain Institute & Department of Psychiatry, University of Calgary, Calgary, AB, Canada T2N 4Z6. acduffy@ucalgary.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23707033

Citation

Duffy, Anne, et al. "Childhood Anxiety: an Early Predictor of Mood Disorders in Offspring of Bipolar Parents." Journal of Affective Disorders, vol. 150, no. 2, 2013, pp. 363-9.
Duffy A, Horrocks J, Doucette S, et al. Childhood anxiety: an early predictor of mood disorders in offspring of bipolar parents. J Affect Disord. 2013;150(2):363-9.
Duffy, A., Horrocks, J., Doucette, S., Keown-Stoneman, C., McCloskey, S., & Grof, P. (2013). Childhood anxiety: an early predictor of mood disorders in offspring of bipolar parents. Journal of Affective Disorders, 150(2), 363-9. https://doi.org/10.1016/j.jad.2013.04.021
Duffy A, et al. Childhood Anxiety: an Early Predictor of Mood Disorders in Offspring of Bipolar Parents. J Affect Disord. 2013 Sep 5;150(2):363-9. PubMed PMID: 23707033.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Childhood anxiety: an early predictor of mood disorders in offspring of bipolar parents. AU - Duffy,Anne, AU - Horrocks,Julie, AU - Doucette,Sarah, AU - Keown-Stoneman,Charles, AU - McCloskey,Shannon, AU - Grof,Paul, Y1 - 2013/05/23/ PY - 2013/02/10/received PY - 2013/04/19/accepted PY - 2013/5/28/entrez PY - 2013/5/28/pubmed PY - 2014/5/6/medline KW - Anxiety disorder KW - Bipolar disorder KW - Clinical course KW - Genetics KW - High-risk offspring KW - Mood disorders SP - 363 EP - 9 JF - Journal of affective disorders JO - J Affect Disord VL - 150 IS - 2 N2 - BACKGROUND: Anxiety disorders are common among the offspring of parents with bipolar disorder (BD). This study investigated the nature of the association between anxiety disorders and mood disorders in a prospectively studied high-risk cohort. METHODS: High-risk offspring were identified from families in which one parent had confirmed BD based on SADS-L interviews and best estimate diagnostic procedures. All agreeable offspring aged 8-25 years were enrolled in a longitudinal study involving repeated KSADS-PL format clinical assessments. Control (C) offspring from families in which neither parent met lifetime criteria for a psychiatric disorder were similarly assessed. All DSM-IV diagnoses in the offspring were confirmed on blind consensus review. Cumulative incidence and adjusted Cox Proportional Hazards models were used to calculate the risk of anxiety disorders and the predictive association with mood disorders. RESULTS: The cumulative incidence of anxiety disorders was higher (23.40% vs. 10.42%; HR=2.136; p=.0382) and occurred earlier (9.79 vs. 14.84 years; p=.0125) in high-risk compared to C offspring. In high-risk offspring generalized anxiety disorders (GAD) followed by social phobia were the most incident anxiety subtypes; while high emotionality (HR 1.111; p=.0096) and shyness (HR 1.144; p=.0053) increased the risk of anxiety disorders. Anxiety disorders increased the adjusted risk of mood disorders (HR 2.166; p=.0004), on average 8.49 years later (SD 5.97). LIMITATIONS: The cumulative incidence of BD is relatively low, as the cohort is still in the period of risk. CONCLUSIONS: Findings highlight the need for longitudinal surveillance of symptomatic high-risk children and suggest anxiety disorders are an important early intervention target. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/23707033/Childhood_anxiety:_an_early_predictor_of_mood_disorders_in_offspring_of_bipolar_parents_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(13)00294-2 DB - PRIME DP - Unbound Medicine ER -