Robert M Post1, Lori L Altshuler2, Ralph Kupka3, Susan L McElroy4, Mark A Frye5, Michael Rowe6, Heinz Grunze7, Trisha Suppes8, Paul E Keck9, Gabriele S Leverich6, Willem A Nolen10. 1. Bipolar Collaborative Network, Bethesda, MD, USA; Department of Psychiatry and Behavioral Sciences, George Washington University, Washington D.C., USA. Electronic address: Robert.post@speakeasy.net. 2. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Department of Psychiatry, VA Greater Los Angeles Healthcare System, West Los Angeles Healthcare Center, Los Angeles, CA, USA. 3. Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 4. Lindner Center of HOPE, Mason, OH, USA; Biological Psychiatry Program, University of Cincinnati Medical College, Cincinnati, OH, USA. 5. Department of Psychiatry, Mayo Clinic, Rochester, MI, USA. 6. Bipolar Collaborative Network, Bethesda, MD, USA. 7. Paracelsus Medical University, Salzburg, Austria. 8. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA; V.A. Palo Alto Health Care System, Palo Alto, CA, USA. 9. Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Lindner Center of HOPE, Mason, OH, USA. 10. University Medical Center, University of Groningen, Groningen, The Netherlands.
Abstract
BACKGROUND: Family history and adversity in childhood are two replicated risk factors for early onset bipolar disorder. However, their combined impact has not been adequately studied. METHODS: Based on questionnaire data from 968 outpatients with bipolar disorder who gave informed consent, the relationship and interaction of: 1) parental and grandparental total burden of psychiatric illness; and 2) the degree of adversity the patient experienced in childhood on their age of onset of bipolar disorder was examined with multiple regression and illustrated with a heat map. RESULTS: The familial loading and child adversity vulnerability factors were significantly related to age of onset of bipolar and their combined effect was even larger. A heat map showed that at the extremes (none of each factor vs high amounts of both) the average age of onset differed by almost 20 years (mean = 25.8 vs 5.9 years of age). LIMITATIONS: The data were not based on interviews of family members and came from unverified answers on a patient questionnaire. CONCLUSIONS: Family loading for psychiatric illness and adversity in childhood combine to have a very large influence on age of onset of bipolar disorder. These variables should be considered in assessment of risk for illness onset in different populations, the need for early intervention, and in the design of studies of primary and secondary prevention.
BACKGROUND: Family history and adversity in childhood are two replicated risk factors for early onset bipolar disorder. However, their combined impact has not been adequately studied. METHODS: Based on questionnaire data from 968 outpatients with bipolar disorder who gave informed consent, the relationship and interaction of: 1) parental and grandparental total burden of psychiatric illness; and 2) the degree of adversity the patient experienced in childhood on their age of onset of bipolar disorder was examined with multiple regression and illustrated with a heat map. RESULTS: The familial loading and child adversity vulnerability factors were significantly related to age of onset of bipolar and their combined effect was even larger. A heat map showed that at the extremes (none of each factor vs high amounts of both) the average age of onset differed by almost 20 years (mean = 25.8 vs 5.9 years of age). LIMITATIONS: The data were not based on interviews of family members and came from unverified answers on a patient questionnaire. CONCLUSIONS: Family loading for psychiatric illness and adversity in childhood combine to have a very large influence on age of onset of bipolar disorder. These variables should be considered in assessment of risk for illness onset in different populations, the need for early intervention, and in the design of studies of primary and secondary prevention.
Authors: Roger S McIntyre; Martin Alda; Ross J Baldessarini; Michael Bauer; Michael Berk; Christoph U Correll; Andrea Fagiolini; Kostas Fountoulakis; Mark A Frye; Heinz Grunze; Lars V Kessing; David J Miklowitz; Gordon Parker; Robert M Post; Alan C Swann; Trisha Suppes; Eduard Vieta; Allan Young; Mario Maj Journal: World Psychiatry Date: 2022-10 Impact factor: 79.683
Authors: Yann Quidé; Leonardo Tozzi; Mark Corcoran; Dara M Cannon; Maria R Dauvermann Journal: Neuropsychiatr Dis Treat Date: 2020-12-14 Impact factor: 2.570
Authors: Robert M Post; Lori L Altshuler; Ralph Kupka; Susan L McElroy; Mark A Frye; Heinz Grunze; Trisha Suppes; Paul E Keck; Willem A Nolen Journal: Int J Bipolar Disord Date: 2021-04-02
Authors: Flore Moulin; Mehdi Gholam; Marie-Pierre F Strippoli; Enrique Castelao; Kathleen R Merikangas; Emma K Stapp; Pierre Marquet; Jean-Michel Aubry; Kerstin J Plessen; Francesca Di Giacomo; Jennifer Glaus; Giorgio Pistis; Benjamin Lavigne; Julien Elowe; Setareh Ranjbar; Martin Preisig; Caroline L Vandeleur Journal: Int J Bipolar Disord Date: 2022-04-06
Authors: Robert M Post; Benjamin I Goldstein; Boris Birmaher; Robert L Findling; Benicio N Frey; Melissa P DelBello; David J Miklowitz Journal: J Affect Disord Date: 2020-03-06 Impact factor: 4.839