Psychiatric phenomenology of child and adolescent bipolar offspring

Objective: To establish prodromal signs of and risk factors for childhood b ipolar disorder (BD) by characterizing youths at high risk for ED. Method: Structured diagnostic interviews were performed on 60 biological offspring of at least one parent with ED. Demographics, family histories, and parenta l history of childhood disruptive behavioral disorders were also assessed. Results: Fifty-one percent of bipolar offspring had a psychiatric disorder, most commonly attention-deficit/hyperactivity disorder (ADHD), major depre ssion or dysthymia, and ED. ED in offspring tended to be associated with ea rlier parental symptom onset when compared with offspring without a psychia tric diagnosis. Bipolar parents with a history of childhood ADHD were more likely to have children with ED, but not ADHD. Offspring with bilineal risk had increased severity of depressed and irritable mood, lack of mood react ivity, and rejection sensitivity, while severity of grandiosity, euphoric m ood, and decreased need for sleep were not preferentially associated with s uch offspring. Conclusions: Bipolar offspring have high levels of psychopat hology. Parental history of early-onset ED and/or childhood ADHD may increa se the risk that their offspring will develop ED. Prodromal symptoms of chi ldhood ED may include more subtle presentations of mood regulation difficul ties and less presence of classic manic symptoms.