BackgroundOffspring of parents with bipolar disorder have increased risks of their own psychopathology. However, a large‐scale survey of psychiatric, somatic, and adverse social outcomes up to adulthood, which could aid in prioritizing and tailoring prevention, is lacking. It also remains to clarify how risks are modified by other parental factors.MethodsSwedish population registers were linked to compare offspring having (N = 24,788) and not having (N = 247,880) a parent with bipolar disorder with respect to psychiatric diagnoses and psychotropic medication, birth‐related and somatic conditions, social outcomes, accidents, suicide attempts, and mortality. Individuals were followed until age 18. We estimated the influence of lifetime parental psychiatric comorbidity, bipolar disorder subtype, and sex on outcomes.ResultsChildren of parents with bipolar disorder had 2–3 times higher risks of all psychiatric diagnoses, except for bipolar disorder, for which the risk was 11‐fold. Significantly increased risks were also found for several somatic conditions, low school grades, criminal behavior, victimization, accidents, and suicidal behavior. Adjusting for lifetime parental psychiatric comorbidity attenuated most associations. Offspring of a parent with bipolar disorder type 2 had statistically significantly higher risks of attention deficit hyperactivity disorder, respiratory tract conditions, and accidents compared with offspring of a parent with bipolar disorder type 1. Offspring of mothers with bipolar disorder had higher risks of several psychiatric diagnoses, respiratory tract conditions, low school grades, and accidents compared with offspring of fathers with bipolar disorder. Having two parents with bipolar disorder entailed the highest risks of psychiatric outcomes in offspring.ConclusionsEarly intervention and family support are particularly warranted for the offspring of a parent with bipolar disorder in the presence of lifetime parental psychiatric comorbidity, when the parent has bipolar disorder type 2, or when the mother or both parents have bipolar disorder.

中文翻译：

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父母患有双相情感障碍的后代的童年和青少年结局：终生父母合并症、父母性别和双相情感障碍亚型的影响


背景父母患有双相情感障碍的后代患自己精神病理学的风险增加。然而，缺乏对成年前的精神、躯体和不良社会结局的大规模调查，这可能有助于确定预防的优先次序和调整预防的重点。还需要澄清其他父因素如何改变风险。方法瑞典种群登记册与比较父母患有双相情感障碍 （N = 24,788） 和没有 （N = 247,880） 的后代在精神病学诊断和精神药物、出生相关和躯体疾病、社会结果、事故、自杀未遂和死亡率方面进行比较。个体被跟踪到 18 岁。我们估计了终生父母精神合并症、双相情感障碍亚型和性别对结局的影响。结果父母患有双相情感障碍的孩子患所有精神病学诊断的风险高 2-3 倍，但双相情感障碍的风险是 11 倍。还发现几种躯体疾病、低学习成绩、犯罪行为、受害、事故和自杀行为的风险显着增加。调整终生父母精神合并症减弱了大多数关联。与患有 1 型双相情感障碍的父母的后代相比，患有 2 型双相情感障碍的父母的后代患注意力缺陷多动障碍、呼吸道疾病和事故的风险在统计学上显著更高。与患有双相情感障碍的父亲的后代相比，患有双相情感障碍的母亲的后代发生多种精神病学诊断、呼吸道疾病、低学习成绩和事故的风险更高。 父母双方都患有双相情感障碍，后代出现精神结局的风险最高。结论当父母终生存在双相情感障碍时，当父母患有 2 型双相情感障碍，或者当母亲或父母双方患有双相情感障碍时，早期干预和家庭支持尤其需要。