Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
J Affect Disord. 2023 Nov 1;340:490-505. doi: 10.1016/j.jad.2023.07.072. Epub 2023 Jul 17.
Whereas the risk and course of psychopathology in offspring of parents with bipolar disorder (BD) have been the primary focus of high-risk offspring studies to date, functional outcomes have not been given much attention. We present a systematic review of functional outcomes and quality of life (QoL) across development in offspring of parents with BD and aim to explore the role of offspring psychopathology in these outcomes.
We searched Embase, MEDLINE, PsycINFO, Web of Science, Cochrane Central, and Google Scholar from inception to June 24, 2022, for studies referring to functional outcomes (global, social, academic or occupational) or QoL in offspring of parents with BD.
From the 6470 records identified, 39 studies were retained (global = 17; social = 17; school = 16; occupational = 3; QoL = 5), including 13 studies that examined multiple domains. For all domains, high heterogeneity was found in study methods and quality. Only 56 % of studies adjusted for offspring psychopathology, impeding interpretation. Global and social functioning generally seemed to be impaired among older offspring (>16 years). Academic performance appeared to be unaffected. School behavior, occupational functioning, and QoL showed mixed results. Offspring psychopathology is associated with social functioning, but the relationship of offspring psychopathology with other domains is less clear.
Studies on functional outcome in offspring of parents with BD show predominantly mixed results. Inconsistent adjustment of psychopathology and age limits conclusive interpretation. Functional outcomes should be prioritized as research topics in high-risk studies and the potential associations between familial risk status, offspring psychopathology, and age may inform prevention strategies.
迄今为止，父母患有双相障碍（BD）的高风险后代研究的主要重点是后代的精神病理学风险和病程，但对功能结果的关注较少。我们对父母患有 BD 的后代在整个发育过程中的功能结果和生活质量（QoL）进行了系统回顾，并旨在探讨后代精神病理学在这些结果中的作用。
我们从 2022 年 6 月 24 日起在 Embase、MEDLINE、PsycINFO、Web of Science、Cochrane 中央和 Google Scholar 上搜索了提到父母患有 BD 的后代的功能结果（总体、社交、学业或职业）或 QoL 的研究。
从 6470 条记录中，保留了 39 项研究（总体=17；社交=17；学校=16；职业=3；QoL=5），其中 13 项研究检查了多个领域。对于所有领域，研究方法和质量的高度异质性。只有 56%的研究调整了后代的精神病理学，阻碍了解释。年龄较大的后代（>16 岁）的总体和社交功能似乎受损。学业成绩似乎未受影响。学校行为、职业功能和 QoL 显示出混合结果。后代的精神病理学与社交功能有关，但后代的精神病理学与其他领域的关系不太清楚。
父母患有 BD 的后代的功能结果研究主要显示出混合的结果。精神病理学和年龄的调整不一致限制了结论的解释。功能结果应作为高风险研究的研究课题优先考虑，家族风险状况、后代精神病理学和年龄之间的潜在关联可能为预防策略提供信息。
