Researchers have found an increased risk for bipolar I disorder in the relatives of children with the condition.

This finding supports the validity of the diagnosis of bipolar I disorder in children, something that has been questioned by many clinicians and researchers, note Janet Wozniak, from Massachusetts General Hospital in Boston, USA, and colleagues.

The researchers conducted structured diagnostic interviews with 157 children with bipolar I disorder, who had been identified through clinical service referrals, along with 487 of their first-degree relatives.

They note that 81% of the children were male, which is consistent with previous reports of male preponderance.

For comparison purposes, 162 children with attention deficit/hyperactivity disorder (ADHD), and 511 of their first-degree relatives, and 136 children without bipolar I disorder or ADHD and 411 of their first-degree relatives were also interviewed.

The bipolar I disorder children had a mean age of 11.6 years, while the ADHD and mentally healthy children had mean ages of 13.7 and 12.9 years, respectively.

The findings, published in the journal Psychological Medicine, show that, after controlling for psychiatric comorbidity in the children, the first-degree relatives of children with bipolar I disorder had a significant, four-fold increased morbid risk for bipolar I disorder compared with the relatives of mentally healthy children.

The first-degree relatives of children with bipolar I disorder were also a significant 3.8 times more likely to have the condition than the first-degree relatives of children with ADHD.

However, there was no significant difference in the risk for bipolar I disorder between the relatives of ADHD and control children, and familial rates of ADHD did not differ between children with ADHD and those with bipolar I disorder.

Wozniak and team also found that pediatric bipolar I disorder was associated with an increased familial risk for syndrome-related psychiatric comorbidity including psychosis, major depression, multiple anxiety disorders, substance use disorders, ADHD, and antisocial disorders.

“These results are consistent with the literature documenting the familiality of pediatric bipolar disorder and suggest that DSM-IV bipolar I disorder diagnostic criteria applied to children is a valid clinical entity worthy of further clinical and scientific attention,” the researchers conclude.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

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