Emerging psychopathology and clinical staging in adolescent offspring of parents with bipolar disorder or schizophrenia—A longitudinal study

Abstract

ObjectivesOffspring of parents with bipolar disorder (BDo) and schizophrenia (SZo) are at increased risk for these disorders and general psychopathology. Little is known about their (dis)similarities in risk and developmental trajectories during adolescence. A clinical staging approach may help define the developmental course of illness.MethodsThe Dutch Bipolar and Schizophrenia Offspring Study is a unique cross‐disorder and prospective cohort study, established in 2010. In total, 208 offspring (58 SZo, 94 BDo, and 56 control offspring [Co]) and their parents participated. Offspring were 13.2 years (SD = 2.5; range: 8–18 years) at baseline and 17.1 years (SD = 2.7) at follow‐up (88.5% retention rate). Psychopathology was assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version, and Achenbach System of Empirically Based Assessment parent‐, self‐ and teacher‐reports. Groups were compared on (1) the presence of categorical psychopathology, (2) timing and development of psychopathology using a clinical staging perspective, and (3) dimensional psychopathology using a multi‐informant approach.ResultsSZo and BDo showed more categorical psychopathology and (sub)clinical symptoms, as compared to Co. SZo have, compared to BDo, an increased risk for developmental disorders, a younger age of onset, and more (sub)clinical symptoms of the mood and behavioral spectrum as reported by multiple informants.ConclusionsOur study shows that the phenotypical risk profile overlaps between SZo and BDo, although an earlier onset of developmental psychopathology was found specifically in SZo, suggesting of a potentially different ethiopathophysiology. Longer follow‐up and future studies are needed.

Age Trajectories of the Structural Connectome in Child and Adolescent Offspring of Individuals With Bipolar Disorder or Schizophrenia

“…It is important to note that most of the offspring in this study have not yet reached the typical age of onset at which the intergenerational homotypic continuity of psychopathology from parent to offspring can be observed ( 11 , 12 , 68 ). While (sub)clinical symptoms in the psychotic and several other domains are present in both high-familial-risk groups, the number of offspring diagnosed with a bipolar or psychotic disorder in this cohort is very low ( 69 ). Because more of them are likely to develop psychosis or bipolar disorder ( 4 , 5 , 6 ), following these offspring further into adulthood is imperative because it will allow us to determine how connectome development pertains to risk of or resilience against later severe mood or psychotic disorder.…”

Circadian rhythm dysfunction and psychopathology in the offspring of parents with bipolar disorder: a high-risk study in the Chinese population

“…6 Previous longitudinal investigations in the offspring of parents with bipolar disorder (O-BD) suggested the emergence of various non-mood disorders prior to the onset of bipolar disorder, including sleep and anxiety disorders in late childhood, adjustment disorders and dysthymia in early adolescence, and major depression in late adolescence. [7][8][9] Recently, there has been a growing consensus that sleep/circadian rhythm dysfunction may be one of the key prodromes as well as core manifestations of bipolar disorder. Existing evidence indicated that sleep alterations may serve as precursors of the initiation of bipolar disorder, and dynamic changes in sleep patterns accounted for one-third of the predictable explained variance in the multivariate psychiatric symptom outcomes.…”