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Early indicators of bipolar risk in preschool offspring of parents with bipolar disorder.

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Title: Early indicators of bipolar risk in preschool offspring of parents with bipolar disorder.
Authors: Hafeman, Danella M., Merranko, John, Joseph, Heather M., Goldstein, Tina R., Goldstein, Benjamin I., Levenson, Jessica, Axelson, David, Monk, Kelly, Sakolsky, Dara, Iyengar, Satish, Birmaher, Boris
Source: Journal of Child Psychology & Psychiatry. Oct2023, Vol. 64 Issue 10, p1492-1500. 9p. 4 Charts.
Subjects: Diagnosis of bipolar disorder, Research, Psychology of parents, Key performance indicators (Management), Children of parents with disabilities, Regression analysis, Mann Whitney U Test, Fisher exact test, Risk assessment, Psychosocial factors, Clinical medicine, Survival analysis (Biometry), Descriptive statistics, Prediction models, Bipolar disorder, Early diagnosis, Proportional hazards models, Disease risk factors, Children
Abstract: Background: Offspring of parents with bipolar disorder (BD‐I/II) are at increased risk to develop the disorder. Previous work indicates that bipolar spectrum disorder (BPSD) is often preceded by mood/anxiety symptoms. In school‐age offspring of parents with BD, we previously built a risk calculator to predict BPSD onset, which generates person‐level risk scores. Here, we test whether preschool symptoms predict school‐age BPSD risk. Methods: We assessed 113 offspring of parents with BD 1–3 times during preschool years (2–5 years old) and then approximately every 2 years for a mean of 10.6 years. We used penalized (lasso) regression with linear mixed models to assess relationships between preschool mood, anxiety, and behavioral symptoms (parent‐reported) and school‐age predictors of BPSD onset (i.e., risk score, subthreshold manic symptoms, and mood lability), adjusting for demographics and parental symptomatology. Finally, we conducted survival analyses to assess associations between preschool symptoms and school‐age onset of BPSD and mood disorder. Results: Of 113 preschool offspring, 33 developed new‐onset mood disorder, including 19 with new‐onset BPSD. Preschool irritability, sleep problems, and parental factors were lasso‐selected predictors of school‐age risk scores. After accounting for demographic and parental factors, preschool symptoms were no longer significant. Lasso regressions to predict mood lability and subthreshold manic symptoms yielded similar predictors (irritability, sleep problems, and parental affective lability), but preschool symptoms remained predictive even after adjusting for parental factors (ps <.005). Exploratory analyses indicated that preschool irritability univariately predicted new‐onset BPSD (p =.02) and mood disorder (p =.02). Conclusions: These results provide initial prospective evidence that, as early as preschool, youth who will develop elevated risk scores, mood lability, and subthreshold manic symptoms are already showing symptomatology; these preschool symptoms also predict new‐onset BPSD. While replication of findings in larger samples is warranted, results point to the need for earlier assessment of risk and development of early interventions. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Child Psychology & Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Early indicators of bipolar risk in preschool offspring of parents with bipolar disorder.
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– Name: Abstract
  Label: Abstract
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  Data: Background: Offspring of parents with bipolar disorder (BD‐I/II) are at increased risk to develop the disorder. Previous work indicates that bipolar spectrum disorder (BPSD) is often preceded by mood/anxiety symptoms. In school‐age offspring of parents with BD, we previously built a risk calculator to predict BPSD onset, which generates person‐level risk scores. Here, we test whether preschool symptoms predict school‐age BPSD risk. Methods: We assessed 113 offspring of parents with BD 1–3 times during preschool years (2–5 years old) and then approximately every 2 years for a mean of 10.6 years. We used penalized (lasso) regression with linear mixed models to assess relationships between preschool mood, anxiety, and behavioral symptoms (parent‐reported) and school‐age predictors of BPSD onset (i.e., risk score, subthreshold manic symptoms, and mood lability), adjusting for demographics and parental symptomatology. Finally, we conducted survival analyses to assess associations between preschool symptoms and school‐age onset of BPSD and mood disorder. Results: Of 113 preschool offspring, 33 developed new‐onset mood disorder, including 19 with new‐onset BPSD. Preschool irritability, sleep problems, and parental factors were lasso‐selected predictors of school‐age risk scores. After accounting for demographic and parental factors, preschool symptoms were no longer significant. Lasso regressions to predict mood lability and subthreshold manic symptoms yielded similar predictors (irritability, sleep problems, and parental affective lability), but preschool symptoms remained predictive even after adjusting for parental factors (ps &lt;.005). Exploratory analyses indicated that preschool irritability univariately predicted new‐onset BPSD (p =.02) and mood disorder (p =.02). Conclusions: These results provide initial prospective evidence that, as early as preschool, youth who will develop elevated risk scores, mood lability, and subthreshold manic symptoms are already showing symptomatology; these preschool symptoms also predict new‐onset BPSD. While replication of findings in larger samples is warranted, results point to the need for earlier assessment of risk and development of early interventions. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Journal of Child Psychology &amp; Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1111/jcpp.13739
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      – SubjectFull: Psychology of parents
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      – SubjectFull: Key performance indicators (Management)
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      – SubjectFull: Children of parents with disabilities
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      – SubjectFull: Psychosocial factors
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      – SubjectFull: Clinical medicine
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      – SubjectFull: Survival analysis (Biometry)
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Children
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      – TitleFull: Early indicators of bipolar risk in preschool offspring of parents with bipolar disorder.
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              Text: Oct2023
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