Editorial: Following Offspring of Parents With Bipolar Disorder Into Middle Adulthood: Risk Windows Relevant to Child Psychiatrists.

The most important predictor of bipolar disorder (BD) onset is a family history. Based on this premise, several offspring studies have recruited and followed offspring of parents with BD into early adulthood, including the Pittsburgh Bipolar Offspring Study, the Canadian Flourish Cohort, and the Dutch Bipolar Offspring Study (DBOS). These studies have shed important light on the incidence and prevalence of BD and other psychopathology in these offspring (11%-13% for BD-I/II), as well as the most important symptom-level and diagnostic predictors of BD in these youth. However, questions remain: What happens to these offspring as they reach middle adulthood? Do they continue to be at risk for BD and other mood disorders? These questions have critical clinical and research implications. Clinically, a better understanding of risk trajectories may inform monitoring, treatment, and our conversations with affected families. From a research perspective, a better understanding of the risk period informs the age range in which to focus future efforts.