(HealthDay News) — Subthreshold manic or hypomanic episodes may be a diagnostic precursor to bipolar disorder in the children of parents with bipolar disorder, according to research published online March 3 in The American Journal of Psychiatry.

David Axelson, MD, of The Ohio State University College of Medicine in Columbus, and colleagues performed a longitudinal assessment of 391 high-risk offspring, aged 6–18 years, and 248 demographically matched offspring of community parents, The authors sought to identify diagnostic risk factors for bipolar disease.

The researchers found that high-risk offspring, compared with community offspring, had significantly higher rates of subthreshold mania or hypomania (13.3 vs. 1.2%); manic, mixed, or hypomanic episodes (9.2 vs. 0.8%); and major depressive episodes (32.0 vs. 14.9%). High-risk offspring also had higher rates of attention-deficit/hyperactivity disorder, disruptive behavior disorders, anxiety disorders, and substance use disorders. Factors associated with subsequent manic, mixed, or hypomanic episodes in high-risk offspring were subthreshold manic or hypomanic episodes (hazard ratio [HR], 2.29), major depressive episodes (HR, 1.99), and disruptive behavior disorders (HR, 2.12). When analyses were restricted to prospective data, the only associated factor was subthreshold manic or hypomanic episodes (HR, 7.57).

“Subthreshold manic or hypomanic episodes were a diagnostic risk factor for the development of manic, mixed, or hypomanic episodes in the offspring of parents with bipolar disorder and should be a target for clinical assessment and treatment research,” the authors write.

Several authors disclosed financial ties to the pharmaceutical, medical publishing, and/or biomedical industries.

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