Family environment of children and adolescents with bipolar parents

Objectives: The effect of family environment on the development of bipolar disorder (BD) in children is not known. We sought to characterize families with children at high risk for developing ED in order to better understand the contributions of family environment to the development of childhood ED. Methods: We collected demographic data and parental ratings on the Family E nvironment Scale (FES) for 56 children (aged 6-18 years) from 36 families w ith at least one biological parent with ED. The cohort had previously been psychiatrically diagnosed according to semistructured interviews. Results: Statistical comparisons with normative data indicated that parents ' ratings were significantly lower on the FES Cohesion and Organization sca les and were significantly higher on the FES Conflict scale. Multivariate a nalyses of variance indicated that families with both parents having a mood disorder had no significantly different FES scores than families with only one parent with a mood disorder (BD). Diagnostic data indicated that while 54% of the children in the sample had an Axis I disorder and 14% had ED, F ES scores did not differ significantly for subjects with or without an Axis I disorder, or with or without ED. Conclusions: Families with a bipolar parent differ from the average family in having less cohesion and organization, and more conflict. Despite this d ifference, it does not appear that the environment alone of families with a bipolar parent determines the outcome of psychopathology in the children, or that the psychopathology of the children determines the family environme nt.