Family environment in families with versus families without parental bipolar disorder: a preliminary comparison study.

OBJECTIVES: To compare family environmental characteristics of families with at least one bipolar parent and families with parents without any Axis I disorder.
METHODS: Family environment of 24 families with at least one parent with bipolar disorder (BPD) and 27 families with healthy parents (healthy families, HF) were assessed using the Family Environment Scale (FES). We compared FES subscale scores between BPD and HF. We also compared FES normative scores with scores of BPD families.
RESULTS: Seventeen (71%) of the 24 BPD families had at least one child with a mood disorder and one (3.7%) of the 27 HF had a child with a mood disorder. Families with BPD reported lower cohesion (p = 0.009) and expressiveness (p = 0.03) scores compared with HF, after controlling for group socioeconomic status differences. Bilineal BPD families had higher cohesion scores than unilineal BPD families (p = 0.05). We found no significant differences in any subscales between BPD families with (n = 9) versus without (n = 15) children with BPD. Compared with normative FES data BPD families reported lower cohesion (C) (p = 0.02) and independence (IND) (p = 0.004) scores and higher conflict (CON) (p = 0.02), intellectual-cultural orientation (ICO) (p = 0.05), moral-religious emphasis (MRE) (p < 0.001) and control (CTL) (p < 0.001) scores.
CONCLUSION: Our results suggest that members of BPD families may have difficulty communicating effectively with one another, suggesting that interventions aimed at improving this may be beneficial to patients with BPD. Results suggest that the impact of different lifestyles in different communities may influence FES scores, and thus it is important to use demographically matched comparison groups.