The Dutch Bipolar Offspring Study: 12-Year Follow-Up

Web‐based integrated bipolar parenting intervention for parents with bipolar disorder: a randomised controlled pilot trial

“…BD impacts negatively on, sleep/wake cycles, impulse control, communication and motivation, which may undermine adaptive parenting (Phelan, Lee, Howe, & Walter, 2006; Vance, Jones, Espie, Bentall, & Tai, 2008); whilst mood variation can trigger inconsistent parenting (David, Styron, & Davidson, 2011; Dolman, Jones, & Howard, 2013). Support for parents with BD is particularly important as their children are at high‐risk for psychiatric conditions, including attention deficit hyperactive disorder (ADHD), depression, anxiety, substance abuse, sleep disorders and BD (Axelson et al., 2015; Duffy, Jones, Goodday, & Bentall, 2016; Mesman, Nolen, Reichart, Wals, & Hillegers, 2013). Despite this, few of these children receive clinical support (Calam, Jones, Sanders, Dempsey, & Sadhnani, 2012; Jones, Tai, Evershed, Knowles, & Bentall, 2006) which risks more severe psychological disorders in later life (Duffy et al., 2016).…”

Challenges and developments in research of the early stages of bipolar disorder

“…41 Study designs for the early stages of BD Offspring studies BD is a highly heritable disorder, with up to 85% of the variance in risk determined by genetic factors; hence, a positive family history is still the best predictive factor for development of the illness. 18,22,23 However, a family history does not merely predict an increased risk of BD. Meta-analyses have shown that, compared to other children, the offspring of a BD parent (OSBP) have an eight-to tenfold increase in lifetime risk of developing BD, but also a threefold lifetime risk of any severe mental disorder (e.g., psychosis) and one-in-two odds for any mental disorder.…”

“…44,45 In addition, studies of OSBP can enhance our understanding of the clinical phenotypes of individuals at high risk of developing BD and demonstrate the heterotypic continuity of problems with a common developmental pattern, involving, e.g., anxiety problems in childhood, a first mood episode in early adolescence, and a (hypo) manic episode in late adolescence or early adulthood. 22,23 Prospective studies have the potential to clarify the illness trajectory by exposing the temporal relationship between childhood difficulties or non-mood problems and later affective pathology or development of BD. Questions as to whether non-mood pathology represents a risk syndrome or earlier manifestation of the disorder or whether it is a concurrent disorder in its own right may be answered by such studies of high-risk children.…”

“…17,22 Indeed, there is convergent evidence from longitudinal studies to support the hypothesis that BD develops in a series of predictable clinical stages in those at genetic risk. 22,23 Nevertheless, few studies have approached the early stages of BD, and data on potential neurobiological differences between early-and late-stage BD are scarce. 12 This is a notable contrast to the field of psychosis, in which a large proportion of research resources has been targeted at understanding, recognizing, and managing early-stage disease.…”

Why the concept of schizophrenia is still alive and kicking

“…Similarly, their statement rings true that the (ultra) high risk concept of schizophrenia, focusing on psychosis as it does, has been proven inadequate in predicting transition to schizophrenia -especially because of this limited focus and even more narrow outcome . Indeed, in adolescence the route to psychiatric illness is broad and rather ill-defined (Mesman et al 2013) providing an interesting field of research into the pathways to psychiatric illness, a field that has indeed been hampered by the aforementioned constricted definition of high-risk.…”