• Bipolar disorders · Jun 2018

    Clinical staging model in offspring of parents with bipolar disorder: a systematic review.

    • Aigli Raouna, Cemre Su Osam, and Angus MacBeth.
    • Department of Clinical and Health Psychology, University of Edinburgh, Edinburgh, UK.
    • Bipolar Disord. 2018 Jun 1; 20 (4): 313-333.

    ObjectiveWe sought to systematically review the literature on the psychiatric risk of offspring of parents with bipolar disorder (OPBD) using a developmental psychopathology framework. The review also sought to establish the utility of clinical stage modelling as a framework for identifying precursor disorders to later onset of bipolar disorder (BD) in OPBD.MethodsA systematic search was performed using EMBASE, PsychINFO and Medline. Reference lists of included studies and previous reviews were also searched. Studies were included if they reported diagnostic outcomes for child, adolescent and young adult offspring of parents diagnosed with BD.ResultsTwenty-six studies were identified representing 21 individual cohorts. The review identified that OBPD present as a high-risk group for a range of mood and non-mood disorders in childhood, adolescence and young adulthood. The trajectory of risk was from non-mood disorders in childhood via non-bipolar mood disorders in early adolescence towards mania/hypomania in late adolescence and early adulthood. From a clinical staging perspective, childhood anxiety disorders were associated with later onset of BD. Recurrent substance use disorder was identified as a risk in OPBD during late adolescence and early adulthood. Quality ratings indicated that studies were methodologically robust.ConclusionsOur review provides evidence for a developmental psychopathology trajectory of precursor risks to BD in OPBD. There is support for clinical stage modelling as a conceptual framework for understanding developmental risk in OPBD and as a tool for developing early and individualized intervention strategies.© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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