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05-08-2013 | Mental health | Article

Family psychopathology increases bipolar disorder risk


Free abstract

medwireNews: Family conflict and parental psychopathology can increase a child’s risk for developing bipolar disorder, research suggests.

Using causal-pie models, Po-Hsiu Kuo (National Taiwan University, Taipei) and team identified paternal substance use, maternal depression, poor parental relationships, and family conflict as risk factors for bipolar disorder.

“The development of bipolar illness can potentially be limited by efficient intervention program targeted on these major factors,” suggest Kuo and team writing in European Psychiatry.

The researchers studied 329 consecutive patients aged 18–70 years with bipolar disorder, 332 of their first-degree relatives (87 fathers, 118 mothers, 102 siblings, and 25 adult children), and 202 psychiatrically healthy controls aged 35–70 years.

The participants, all of whom were of Han Chinese ethnicity, were assessed using the World Health Organization Mental Health 2000 version of the Composite International Diagnostic Interview.

Comparison of demographic features revealed that bipolar disorder patients had a lower socioeconomic status and a higher frequency of parental psychopathology and were more likely to have poor family relationships than controls, report Kuo et al.

In a multivariate analysis, there were three significant independent predictors for the development of bipolar disorder: paternal depression, maternal neurosis, and a poor relationship with parents, with odds ratios of 56.7, 14.8, and 1.2, respectively.

A separate multivariate model showed that the risk for bipolar disorder increased in line with the number of parental psychopathologies; this was true for both maternal and paternal psychopathologies.

Finally, the team identified four causal-pies for the development bipolar disorder. The largest pie (73.0%) featured paternal substance use as well as other unmeasured (genetic or environmental) factors; the second pie (17.6%) involved maternal depression and other unmeasured factors; and the third (6.3%) required both poor relationship with parents and conflict within the family. The remaining 3.1% of causal-pie weight was attributed to factors that were not measured in the current sample.

Noting that “a number of important genetic risk factors likely contribute to the development of bipolar disorder,” Kuo et al conclude: “While changing or reducing genetic risk is not easy to implement, relevant family characteristics that are identified in our study provide useful clinical implications that can be utilized in designing intervention programs to target specific family factors that can lower the risk for bipolar illness.”

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Joanna Lyford, Senior medwireNews Reporter

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