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Risk and coaggregation of major psychiatric disorders among first-degree relatives of patients with bipolar disorder: a nationwide population-based study

Published online by Cambridge University Press:  12 November 2018

Mu-Hong Chen Open the ORCID record for Mu-Hong Chen [Opens in a new window] ,
Ju-Wei Hsu ,
Kei-Lin Huang ,
Tung-Ping Su ,
Cheng-Ta Li ,
Wei-Chen Lin ,
Shih-Jen Tsai ,
Chih-Ming Cheng ,
Wen-Han Chang  and
Tai-Long Pan
...Show all authors
Mu-Hong Chen
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Ju-Wei Hsu
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Kei-Lin Huang
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Tung-Ping Su*
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
Cheng-Ta Li
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Wei-Chen Lin
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Shih-Jen Tsai
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Chih-Ming Cheng
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Wen-Han Chang
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
Tai-Long Pan
Affiliation:
School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan Research Center for Chinese Herbal Medicine and Research Center for Food and Cosmetic Safety, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
Tzeng-Ji Chen
Affiliation:
Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
Ya-Mei Bai*
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
*
Author for correspondence: Ya-Mei Bai, E-mail: [email protected] and Tung-Ping Su, E-mail: [email protected]
Author for correspondence: Ya-Mei Bai, E-mail: [email protected] and Tung-Ping Su, E-mail: [email protected]
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Abstract

Background

Bipolar disorder is a highly heritable mental illness that transmits intergeneratively. Previous studies supported that first-degree relatives (FDRs), such as parents, offspring, and siblings, of patients with bipolar disorder, had a higher risk of bipolar disorder. However, whether FDRs of bipolar patients have an increased risk of schizophrenia, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) remains unclear.

Methods

Among the entire population in Taiwan, 87 639 patients with bipolar disorder and 188 290 FDRs of patients with bipolar disorder were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with bipolar disorder.

Results

FDRs of patients with bipolar disorder were more likely to have a higher risk of major psychiatric disorders, including bipolar disorder (RR 6.12, 95% confidence interval (CI) 5.95–6.30), MDD (RR 2.89, 95% CI 2.82–2.96), schizophrenia (RR 2.64, 95% CI 2.55–2.73), ADHD (RR 2.21, 95% CI 2.13–2.30), and ASD (RR 2.10, 95% CI 1.92–2.29), than the total population did. These increased risks for major psychiatric disorders were consistent across different familial kinships, such as parents, offspring, siblings, and twins. A dose-dependent relationship was also found between risk of each major psychiatric disorder and numbers of bipolar patients.

Conclusions

Our study was the first study to support the familial coaggregation of bipolar disorder with other major psychiatric disorders, including schizophrenia, MDD, ADHD, and ASD, in a Taiwanese (non-Caucasian) population. Given the elevated risks of major psychiatric disorders, the public health government should pay more attention to the mental health of FDRs of patients with bipolar disorder.

Keywords

ADHDASDbipolar disorderfamilial co-aggregationfirst-degree relativesMDDschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 14 , October 2019 , pp. 2397 - 2404
Copyright
Copyright © Cambridge University Press 2018 

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References

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 and Birmaher, B (2015) Diagnostic precursors to bipolar disorder in offspring of parents with bipolar disorder: a longitudinal study. Amercian Journal of Psychiatry 172, 638–646.Google Scholar
Birmaher, B, Axelson, D, Monk, K, Kalas, C, Goldstein, B, Hickey, MB, Obreja, M, Ehmann, M, Iyengar, S, Shamseddeen, W, Kupfer, D and Brent, D (2009) Lifetime psychiatric disorders in school-aged offspring of parents with bipolar disorder: the Pittsburgh Bipolar Offspring study. Archives of General Psychiatry 66, 287–296.Google Scholar
Birmaher, B, Axelson, D, Goldstein, B, Monk, K, Kalas, C, Obreja, M, Hickey, MB, Iyengar, S, Brent, D, Shamseddeen, W, Diler, R and Kupfer, D (2010) Psychiatric disorders in preschool offspring of parents with bipolar disorder: the Pittsburgh Bipolar Offspring Study (BIOS). Amercian Journal of Psychiatry 167, 321–330.Google Scholar
Blanco, C, Compton, WM, Saha, TD, Goldstein, BI, Ruan, WJ, Huang, B and Grant, BF (2017) Epidemiology of DSM-5 bipolar I disorder: results from the national epidemiologic survey on alcohol and related conditions - III. Journal of Psychiatric Research 84, 310–317.Google Scholar
Chen, MH, Su, TP, Chen, YS, Hsu, JW, Huang, KL, Chang, WH and Bai, YM (2013) Attention deficit hyperactivity disorder, tic disorder, and allergy: is there a link? A nationwide population-based study. Journal of Child Psychology Psychiatry 54, 545–551.Google Scholar
Chen, MH, Pan, TL, Hsu, JW, Huang, KL, Su, TP, Li, CT, Lin, WC, Tsai, SJ, Chang, WH, Chen, TJ and Bai, YM (2016) Attention-deficit hyperactivity disorder comorbidity and antidepressant resistance among patients with major depression: a nationwide longitudinal study. European Neuropsychopharmacology 26, 1760–1767.Google Scholar
Chen, MH, Hsu, JW, Huang, KL, Bai, YM, Ko, NY, Su, TP, Li, CT, Lin, WC, Tsai, SJ, Pan, TL, Chang, WH and Chen, TJ (2018) Sexually transmitted infection among adolescents and young adults with attention-deficit/hyperactivity disorder: a nationwide longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry 57, 48–53.Google Scholar
Cheng, CM, Chang, WH, Chen, MH, Tsai, CF, Su, TP, Li, CT, Tsai, SJ, Hsu, JW, Huang, KL, Lin, WC, Chen, TJ and Bai, YM (2018) Co-aggregation of major psychiatric disorders in individuals with first-degree relatives with schizophrenia: a nationwide population-based study. Molecular Psychiatry 23, 1756–1763.Google Scholar
Cross-Disorder Group of the Psychiatric Genomics Consortium (2013 a) Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs. Nature Genetics 45, 984–994.Google Scholar
Cross-Disorder Group of the Psychiatric Genomics Consortium (2013 b) Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis. Lancet 381, 1371–1379.Google Scholar
Grande, I, Berk, M, Birmaher, B and Vieta, E (2016) Bipolar disorder. Lancet 387, 1561–1572.Google Scholar
Kuo, CF, Grainge, MJ, Valdes, AM, See, LC, Luo, SF, Yu, KH, Zhang, W and Doherty, M (2015) Familial aggregation of systemic lupus erythematosus and coaggregation of autoimmune diseases in affected families. JAMA Internal Medicine 175, 1518–1526.Google Scholar
Lin, PI, McInnis, MG, Potash, JB, Willour, V, MacKinnon, DF, DePaulo, JR and Zandi, PP (2006) Clinical correlates and familial aggregation of age at onset in bipolar disorder. American Journal of Psychiatry 163, 240–246.Google Scholar
Maier, W, Lichtermann, D, Minges, J, Hallmayer, J, Heun, R, Benkert, O and Levinson, DF (1993) Continuity and discontinuity of affective disorders and schizophrenia. Results of a controlled family study. Archives of General Psychiatry 50, 871–883.Google Scholar
McGuffin, P, Rijsdijk, F, Andrew, M, Sham, P, Katz, R and Cardno, A (2003) The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Archives of General Psychiatry 60, 497–502.Google Scholar
Merikangas, KR, Cui, L, Kattan, G, Carlson, GA, Youngstrom, EA and Angst, J (2012) Mania with and without depression in a community sample of US adolescents. Archives of General Psychiatry 69, 943–951.Google Scholar
Merikangas, KR, Cui, L, Heaton, L, Nakamura, E, Roca, C, Ding, J, Qin, H, Guo, W, Shugart, YY, Zarate, C and Angst, J (2014) Independence of familial transmission of mania and depression: results of the NIMH family study of affective spectrum disorders. Molecular Psychiatry 19, 214–219.Google Scholar
Mesman, E, Nolen, WA, Reichart, CG, Wals, M and Hillegers, MH (2013) The Dutch bipolar offspring study: 12-year follow-up. American Journal of Psychiatry 170, 542–549.Google Scholar
Muller-Oerlinghausen, B, Berghofer, A and Bauer, M (2002) Bipolar disorder. Lancet 359, 241–247.Google Scholar
Rasic, D, Hajek, T, Alda, M and Uher, R (2014) Risk of mental illness in offspring of parents with schizophrenia, bipolar disorder, and major depressive disorder: a meta-analysis of family high-risk studies. Schizophrenia Bulletin 40, 28–38.Google Scholar
Song, J, Bergen, SE, Kuja-Halkola, R, Larsson, H, Landen, M and Lichtenstein, P (2015) Bipolar disorder and its relation to major psychiatric disorders: a family-based study in the Swedish population. Bipolar Disorders 17, 184–193.Google Scholar
Sucksdorff, D, Chudal, R, Suominen, A, Jokiranta, E, Brown, AS and Sourander, A (2014) Bipolar disorder and parental psychopathology. Social Psychiatry and Psychiatric Epidemiology 49, 1973–1984.Google Scholar
Vandeleur, CL, Merikangas, KR, Strippoli, MP, Castelao, E and Preisig, M (2014) Specificity of psychosis, mania and major depression in a contemporary family study. Molecular Psychiatry 19, 209–213.Google Scholar
Weissman, MM, Bland, RC, Canino, GJ, Faravelli, C, Greenwald, S, Hwu, HG, Joyce, PR, Karam, EG, Lee, CK, Lellouch, J, Lepine, JP, Newman, SC, Rubio-Stipec, M, Wells, JE, Wickramaratne, PJ, Wittchen, H and Yeh, EK (1996) Cross-national epidemiology of major depression and bipolar disorder. JAMA 276, 293–299.Google Scholar
Yelland, LN, Salter, AB and Ryan, P (2011) Performance of the modified Poisson regression approach for estimating relative risks from clustered prospective data. American Journal of Epidemiology 174, 984–992.Google Scholar
Zou, G (2004) A modified Poisson regression approach to prospective studies with binary data. American Journal of Epidemiology 159, 702–706.Google Scholar
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