Higher socioeconomic status and less parental psychopathology improve prognosis in youths with bipolar disorder

Diler, Rasim Somer; Merranko, John; Hafeman, Danella; Goldstein, Tina R.; Goldstein, Benjamin I.; Hower, Heather; Gill, Mary Kay; Axelson, David; Keller, Martin B.; Yen, Shirley; Hunt, Jeffrey; Weinstock, Lauren M.; Iyengar, Satish; Birmaher, Boris

doi:10.1016/j.jad.2022.01.058

Cited by 5 publications

(5 citation statements)

References 45 publications

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“…Each patient with a schizophrenia or BPI diagnosis was matched to (1) a patient with MDD but no diagnosis of BPI or schizophrenia and (2) a patient without a diagnosis of BPI, schizophrenia, or MDD (GH cohort). We selected variables for matching based on known confounders in the occurrence of disruptive life events . Comparison groups were matched via SAS’s greedy matching algorithm, which matched control patients exactly on sex, race (African American, Asian, White, other/unknown), Medicaid status (KPSC only), and incident and prevalent diagnosis (in the case of the MDD comparison group).…”

Section: Methodsmentioning

confidence: 99%

“…We selected variables for matching based on known confounders in the occurrence of disruptive life events. [31][32][33] Comparison groups were matched via SAS's greedy matching algorithm, which matched control patients exactly on sex, race (African American, Asian, White, other/unknown), Medicaid status (KPSC only), and incident and prevalent diagnosis (in the case of the MDD comparison group). All data for matching came from the EHR.…”

Section: Key Pointsmentioning

confidence: 99%

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Assessment of Disruptive Life Events for Individuals Diagnosed With Schizophrenia or Bipolar I Disorder Using Data From a Consumer Credit Reporting Agency

et al. 2023

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ImportanceThere is a dearth of population-level data on major disruptive life events (defined here as arrests by a legal authority, address changes, bankruptcy, lien, and judgment filings) for patients with bipolar I disorder (BPI) or schizophrenia, which has limited studies on mental health and treatment outcomes.ObjectiveTo conduct a population-level study on disruptive life events by using publicly available data on disruptive life events, aggregated by a consumer credit reporting agency in conjunction with electronic health record (EHR) data.Design, Setting, and ParticipantsThis study used EHR data from 2 large, integrated health care systems, Kaiser Permanente Southern California and Henry Ford Health. Cohorts of patients diagnosed from 2007 to 2019 with BPI or schizophrenia were matched 1:1 by age at analysis, age at diagnosis (if applicable), sex, race and ethnicity, and Medicaid status to (1) an active comparison group with diagnoses of major depressive disorder (MDD) and (2) a general health (GH) cohort without diagnoses of BPI, schizophrenia, or MDD. Patients with diagnoses of BPI or schizophrenia and their respective comparison cohorts were matched to public records data aggregated by a consumer credit reporting agency (98% match rate). Analysis took place between November 2020 and December 2022.Main Outcomes and MeasuresThe differences in the occurrence of disruptive life events among patients with BPI or schizophrenia and their comparison groups.ResultsOf 46 167 patients, 30 008 (65%) had BPI (mean [SD] age, 42.6 [14.2] years) and 16 159 (35%) had schizophrenia (mean [SD], 41.4 [15.1] years). The majoriy of patients were White (30 167 [65%]). In addition, 18 500 patients with BPI (62%) and 6552 patients with schizophrenia (41%) were female. Patients with BPI were more likely to change addresses than patients in either comparison cohort (with the incidence ratio being as high as 1.25 [95% CI, 1.23-1.28]) when compared with GH cohort. Patients with BPI were also more likely to experience any of the financial disruptive life events with odds ratio ranging from 1.15 [95% CI, 1.07-1.24] to 1.50 [95% CI, 1.42-1.58]). The largest differences in disruptive life events were seen in arrests of patients with either BPI or schizophrenia compared with GH peers (3.27 [95% CI, 2.84-3.78] and 3.04 [95% CI, 2.57-3.59], respectively). Patients with schizophrenia had fewer address changes and were less likely to experience a financial event than their matched comparison cohorts.Conclusions and RelevanceThis study demonstrated that data aggregated by a consumer credit reporting agency can support population-level studies on disruptive life events among patients with BPI or schizophrenia.

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Section: Methodsmentioning

confidence: 99%

Section: Key Pointsmentioning

confidence: 99%

Assessment of Disruptive Life Events for Individuals Diagnosed With Schizophrenia or Bipolar I Disorder Using Data From a Consumer Credit Reporting Agency

et al. 2023

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“…Parental (i.e., maternal and paternal) education, age at MRI scan, and total GMV were included as control covariates due to known correlations with HPT from prior behavioral analyses( Arnold 2003 ; Benninghoff and Brieger 2018 ; Cahn et al. 2021 ; Diler et al. 2022 ).…”

Section: Methodsmentioning

confidence: 99%

Neuroanatomical and functional substrates of the hypomanic personality trait and its prediction on aggression

Zhu

Chen

Wang

et al. 2023

International Journal of Clinical and Health Psychology

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“…Data suggest that lithium‐responding parents have fewer ill offspring than non‐lithium responders (Duffy et al., 2020). BIOS data suggest that successful treatment of parent's comorbid substance use disorder improves their socioeconomic situation improving the child's illness course (Diler et al., 2022).…”

mentioning

confidence: 99%

“…The logical best treatment for high‐risk young children is stabilizing their parents' mood disorder and comorbidities. Not only does circumstantial evidence suggest healthier parents are better for their high‐risk children in the long run (Diler et al., 2022; Duffy et al., 2020), there are more evidence‐based treatments for bipolar disorder in adults than there are for children! While there might be data to suggest we can delay episode recurrence, demonstrating true prevention of bipolar disorder is aspirational at best for the time being.…”

mentioning

confidence: 99%

Does the apple fall far from the tree? Commentary on Hafeman et al., early indicators of bipolar risk in preschool offspring of parents with bipolar disorder

Carlson

2023

Child Psychology Psychiatry

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Comorbid externalizing and internalizing disorders are common in offspring of a parent with bipolar I or II disorder. In some cases, the symptoms are harbingers of future bipolar spectrum disorder. Even when they are not, they are likely to be impairing to the child. Clinicians need to be better informed about how the history leading up to mania/hypomania unfolds, and what comorbid disorders are impairing in and of themselves. More information is needed about the parents' psychopathology, course of illness and response to treatment. Until we have data on how to prevent bipolar disorder, the best course of action is to treat the child's current impairing symptoms and render the parent as asymptomatic as possible.

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Higher socioeconomic status and less parental psychopathology improve prognosis in youths with bipolar disorder

Cited by 5 publications

References 45 publications

Assessment of Disruptive Life Events for Individuals Diagnosed With Schizophrenia or Bipolar I Disorder Using Data From a Consumer Credit Reporting Agency

Assessment of Disruptive Life Events for Individuals Diagnosed With Schizophrenia or Bipolar I Disorder Using Data From a Consumer Credit Reporting Agency

Neuroanatomical and functional substrates of the hypomanic personality trait and its prediction on aggression

Does the apple fall far from the tree? Commentary on Hafeman et al., early indicators of bipolar risk in preschool offspring of parents with bipolar disorder

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