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Developmental evaluation of family functioning deficits in youths and young adults with childhood-onset bipolar disorder.

ABSTRACT: BACKGROUND:Childhood-onset bipolar disorder (BD) is a serious condition that affects the patient and family. While research has documented familial dysfunction in individuals with BD, no studies have compared developmental differences in family functioning in youths with BD vs. adults with prospectively verified childhood-onset BD. METHODS:The Family Assessment Device (FAD) was used to examine family functioning in participants with childhood-onset BD (n?=?116) vs. healthy controls (HCs) (n?=?108), ages 7-30 years, using multivariate analysis of covariance and multiple linear regression. RESULTS:Participants with BD had significantly worse family functioning in all domains (problem solving, communication, roles, affective responsiveness, affective involvement, behavior control, general functioning) compared to HCs, regardless of age, IQ, and socioeconomic status. Post-hoc analyses suggested no influence for mood state, global functioning, comorbidity, and most medications, despite youths with BD presenting with greater severity in these areas than adults. Post-hoc tests eliminating participants taking lithium (n?=?17) showed a significant diagnosis-by-age interaction: youths with BD had worse family problem solving and communication relative to HCs. LIMITATIONS:Limitations include the cross-sectional design, clinical differences in youths vs. adults with BD, ambiguity in FAD instructions, participant-only report of family functioning, and lack of data on psychosocial treatments. CONCLUSIONS:Familial dysfunction is common in childhood-onset BD and endures into adulthood. Early identification and treatment of both individual and family impairments is crucial. Further investigation into multi-level, family-based mechanisms underlying childhood-onset BD may clarify the role family factors play in the disorder, and offer avenues for the development of novel, family-focused therapeutic strategies.

SUBMITTER: MacPherson HA

PROVIDER: S-EPMC5976258 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Developmental evaluation of family functioning deficits in youths and young adults with childhood-onset bipolar disorder.

MacPherson Heather A HA Ruggieri Amanda L AL Christensen Rachel E RE Schettini Elana E Kim Kerri L KL Thomas Sarah A SA Dickstein Daniel P DP

Journal of affective disorders 20180416

<h4>Background</h4>Childhood-onset bipolar disorder (BD) is a serious condition that affects the patient and family. While research has documented familial dysfunction in individuals with BD, no studies have compared developmental differences in family functioning in youths with BD vs. adults with prospectively verified childhood-onset BD.<h4>Methods</h4>The Family Assessment Device (FAD) was used to examine family functioning in participants with childhood-onset BD (n = 116) vs. healthy control ...[more]

PMID: 29702451

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Project description:ObjectivesStudies in children of patients affected with bipolar disorder (BD; bipolar offspring) are at high risk to develop mood disorders. Our aim is to investigate how environmental factors such as childhood trauma and family functioning relate to the development of mood disorders in offspring at familial risk for BD.DesignThe current study is part of a longitudinal prospective cohort study among offspring of parents with BD.MethodsThe current study is part of the Dutch Bipolar Offspring Study, an ongoing prospective cohort study among adolescent offspring of a parent with BD. Bipolar offspring were psychiatrically evaluated at baseline and at 1-, 5-, and 12-year follow-up. Complete follow-up data over de 12-year follow-up were available for 102 offspring. Childhood trauma was measured with the Childhood Trauma Questionnaire (CTQ) and filled out by the offspring. Family functioning was reported by the mother with the 130-item Questionnaire for Family Problems (QFP).ResultsEmotional maltreatment was significantly associated (HR = 1.82, CI 1.18-2.82, p = .007) with mood disorder onset in bipolar offspring. No association was found with the family functioning total score (HR = 1.04, CI 0.94-15, p = .085) nor its subscales.ConclusionsThe current study suggests that emotional maltreatment is associated with mood disorder development in bipolar offspring. Remarkably, the association of offspring-reported emotional maltreatment and mood disorder onset was not reflected in parent-reported family functioning (e.g., support and communication, openness or involvement). Possible explanations are discussed and warrant further study.Practitioner pointsOffspring of bipolar patients are at increased risk of developing mood disorders across the life-time. Emotional trauma contributes to the likelihood of developing mood disorders in bipolar offspring. In the daily treatment of bipolar patients having children, attention should be given to parental style and difficulties. Further research using multiple informant methods on childhood trauma an family functioning is needed to further disentangle the effects of these variables on the onset of psychopathology in bipolar offspring.

Dataset Information

Developmental evaluation of family functioning deficits in youths and young adults with childhood-onset bipolar disorder.

Publications

Developmental evaluation of family functioning deficits in youths and young adults with childhood-onset bipolar disorder.

Similar Datasets

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