If a child or teenager has parents with bipolar disorder, there's a strong chance that young person will go on to develop early-onset bipolar disorder, mood disorders, and/or anxiety disorders, new research in the March issue of Archives of General Psychiatry shows. Further, symptoms of bipolar disorder appear to show up before age 21 in 60% of patients.

"Therefore, carefully evaluating and prospectively following the psychopathology of offspring of parents with bipolar disorder and comparing them with offspring of parents with and without non-bipolar disorder psychopathology, are critical for identifying the early clinical presentation of bipolar disorder," study authors wrote.

In this study, Boris Birmaher, MD, and colleagues compared 388 offspring (ages 6 to 18) of 233 parents with bipolar disorder to 251 offspring of 143 control parents. Assessments documented psychiatric disorders, family psychiatric history and family environment. Researchers evaluated children directly for bipolar disorder and other psychiatric disorders without awareness of their parents' diagnoses.

Compared with the offspring of controls, children of parents with bipolar disorder saw an elevated risk of bipolar spectrum disorder (41 or 10.6% vs. 2 or 0.8%) and or any mood or anxiety disorder. In families where both parents had bipolar disorders, those children had greater chance of developing the condition than children in families where one parent had bipolar disorder (4 of 14 or 28.6% vs. 37 of 374 or 9.9%).

"Clinicians who treat adults with bipolar disorder should question those who are parents about their children's psychopathology to offer prompt identification and early interventions for any psychiatric problems that may be affecting the children's functioning, particularly early-onset bipolar disorder," the authors suggested.

The study was supported by a grant from the National Institute of Mental Health.