Children at Risk for Bipolar

children at risk for bipolarGreater Mental Health Risks For Children Of Bipolar Parents

From the American Journal of Psychiatry:

David Axelson and colleagues find that, within seven years, 74.2% of children of parents with bipolar disorder will receive a major (Axis 1) psychiatric diagnosis. And are themselves at risk for bipolar disorder, anxiety, depression, and other disorders.

This same group of offspring carries a troubling attaché of statistics. Compared to children of non-bipolar parentage, they are more likely to experience subthreshold mania or hypomania—otherwise known as bipolar disorder not otherwise specified, or BP-NOS—at a rate of about 13 percent and 1 percent, respectively.

They are also more likely to have manic, mixed or hypomanic episodes (about 9 percent versus less than 1 percent); major depressive episodes (32 percent versus 15 percent); and anxiety disorders (about 40 percent versus 22 percent), when compared to children who do not have bipolar parents.

Axelson et al.’s longitudinal study compared two groups of children, ages 6 – 18. There were 391 children in the first group, and each child had at least one bipolar parent, while the 248 children in the second group had parents without bipolar disorder.

For about seven years, follow-up assessments were administered to the children and adolescents every two and a half years, analyzing symptoms that had occurred since the last assessment.

The study showed that high-risk children were more likely to display ADHD, too, as well as disruptive behavior disorders and anxiety disorders.

The high-risk group had a diagnosis rate of bipolar spectrum disorders of 23 percent, compared to the low-risk group at 3.2 percent.

Knowing the risks—the gravity, range and likelihood—for children of bipolar parents developing a particular disorder, what can you do to help? How can you mitigate misdiagnosis and help your own child’s and other children’s positive treatment outcomes?

One thing you can do easily is raise your own awareness of what the precursors to mania are—such as BP-NOS and other non-mood disorders (e.g. ADHD). Also monitor symptoms and get appropriate evaluation. This part is tough, because of the range of symptoms, types of illness and dysfunction, and difficulty in finding the right clinician.

(A qualified clinician should not only be able to assess your child for symptoms, but also differentiate symptoms from those of depression and other disorders.)

You can also reach out into your community. If you’re having trouble educating yourself, or believe your child may be at risk for bipolar disorder, you might consider joining Child Network [link here], a study that is collecting information on at-risk children, their treatment, and treatment success.

Tracking symptoms and treatment responses over time can, upon future treatment, improve prognoses, as well as assist pediatricians and family doctors with early detection.

Eric Baron


Axelson D, Goldstein B, Goldstein T, Monk K, Yu H, Hickey MB, Sakolsky D, Diler R, Hafeman D, Merranko J, Iyengar S, Brent D, Kupfer D, Birmaher B. Diagnostic precursors to bipolar disorder in offspring of parents with bipolar disorder: A longitudinal study. American Journal of Psychiatry. 2015 Mar. doi: 10.1176/appi.ajp.2014.14010035.

For more information

Children of Bipolar Parents