Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA.
Am J Psychiatry. 2010 Mar;167(3):321-30. doi: 10.1176/appi.ajp.2009.09070977. Epub 2010 Jan 15.
The authors evaluated lifetime prevalence and specificity of DSM-IV psychiatric disorders and severity of depressive and manic symptoms at intake in preschool offspring of parents with bipolar I and II disorders.
A total of 121 offspring ages 2-5 years from 83 parents with bipolar disorder and 102 offspring of 65 demographically matched comparison parents (29 with non-bipolar psychiatric disorders and 36 without any lifetime psychopathology) were recruited for the study. Parents with bipolar disorder were recruited through advertisements and adult outpatient clinics, and comparison parents were ascertained at random from the community. Participants were evaluated with standardized instruments. All staff were blind to parental diagnoses.
After adjustment for within-family correlations and both biological parents' non-bipolar psychopathology, offspring of parents with bipolar disorder, particularly those older than age 4, showed an eightfold greater lifetime prevalence of attention deficit hyperactivity disorder (ADHD) and significantly higher rates of having two or more psychiatric disorders compared to the offspring of the comparison parents. While only three offspring of parents with bipolar disorder had mood disorders, offspring of parents with bipolar disorder, especially those with ADHD and oppositional defiant disorder, had significantly more severe current manic and depressive symptoms than comparison offspring.
Preschool offspring of parents with bipolar disorder have an elevated risk for ADHD and have greater levels of subthreshold manic and depressive symptoms than children of comparison parents. Longitudinal follow-up is warranted to evaluate whether these children are at high risk for developing mood and other psychiatric disorders.
作者评估了双相 I 型和 II 型障碍父母的学龄前子女一生中出现 DSM-IV 精神障碍的患病率和特异性，以及在入组时抑郁和躁狂症状的严重程度。
共有 83 名双相障碍父母的 121 名 2-5 岁子女和 102 名 65 名匹配的对照父母的 102 名子女（29 名患有非双相精神障碍，36 名无任何终生精神病理学）入组本研究。双相障碍父母通过广告和成人门诊招募，对照父母则随机从社区中确定。参与者接受了标准化工具的评估。所有工作人员均对父母的诊断不知情。
在调整了家族内相关性以及父母双方的非双相精神病理学后，双相障碍父母的子女，尤其是 4 岁以上的子女，出现注意力缺陷多动障碍（ADHD）的终生患病率高出 8 倍，且出现两种或两种以上精神障碍的比率明显高于对照父母的子女。虽然只有 3 名双相障碍父母的子女患有心境障碍，但双相障碍父母的子女，尤其是患有 ADHD 和对立违抗性障碍的子女，当前的躁狂和抑郁症状严重程度明显高于对照子女。
双相障碍父母的学龄前子女患有 ADHD 的风险增加，且存在亚临床躁狂和抑郁症状的程度高于对照父母的子女。需要进行纵向随访以评估这些儿童是否存在发生心境和其他精神障碍的高风险。
