The Nature of the Familial Risk for Psychosis in Bipolar Disorder
(2024) In Schizophrenia Bulletin 50(1). p.157-165- Abstract
Background and Hypothesis: To clarify whether the familial liability to psychosis associated with bipolar disorder (BD) is nonspecific or has a greater effect on risk for psychosis in cases with prominent mood symptoms and/or a remitting course. Study Design: We examined, in 984 809 offspring raised in intact families in Sweden, born 1980-1996 and followed-up through 2018, by multivariable Cox proportional hazards regression, risk in offspring of parents with BD for 7 psychotic disorders: Psychotic MD (PMD), psychotic BD (PBD), schizoaffective disorder (SAD), acute psychoses, psychosis NOS, delusional disorder (DD) and schizophrenia (SZ). Diagnoses were obtained from national registers. Study Results: In the offspring of BD parents, the... (More)
Background and Hypothesis: To clarify whether the familial liability to psychosis associated with bipolar disorder (BD) is nonspecific or has a greater effect on risk for psychosis in cases with prominent mood symptoms and/or a remitting course. Study Design: We examined, in 984 809 offspring raised in intact families in Sweden, born 1980-1996 and followed-up through 2018, by multivariable Cox proportional hazards regression, risk in offspring of parents with BD for 7 psychotic disorders: Psychotic MD (PMD), psychotic BD (PBD), schizoaffective disorder (SAD), acute psychoses, psychosis NOS, delusional disorder (DD) and schizophrenia (SZ). Diagnoses were obtained from national registers. Study Results: In the offspring of BD parents, the hazard ratios (HR) for these 7 disorders formed an inverted U-shaped curve, rising from 2.98 for PMD, to peak at 4.49 for PBD and 5.25 for SAD, and then declining to a HR of 3.48 for acute psychoses and 3.22 for psychosis NOS, to a low of 2.19 for DD and 2.33 for SZ. A similar pattern of risks was seen in offspring of mothers and fathers affected with BD and in offspring predicted from age at onset in their BD parent. Conclusions: The BD-Associated risk for psychosis impacts most strongly on mood disorders, moderately on episodic psychotic syndromes, and least on chronic psychotic disorders. These results support prior clinical studies suggesting a qualitative difference in the familial substrate for psychosis occurring in BD and SZ.
(Less)
- author
- Kendler, Kenneth S. LU ; Abrahamsson, Linda LU ; Sundquist, Jan LU and Sundquist, Kristina LU
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Schizophrenia Bulletin
- volume
- 50
- issue
- 1
- pages
- 9 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85181165152
- pmid:37440202
- ISSN
- 0586-7614
- DOI
- 10.1093/schbul/sbad097
- language
- English
- LU publication?
- yes
- id
- 065277b2-5d79-4a08-85ed-cf1873cdfe41
- date added to LUP
- 2024-02-06 14:50:43
- date last changed
- 2024-08-28 03:57:58
@article{065277b2-5d79-4a08-85ed-cf1873cdfe41, abstract = {{<p>Background and Hypothesis: To clarify whether the familial liability to psychosis associated with bipolar disorder (BD) is nonspecific or has a greater effect on risk for psychosis in cases with prominent mood symptoms and/or a remitting course. Study Design: We examined, in 984 809 offspring raised in intact families in Sweden, born 1980-1996 and followed-up through 2018, by multivariable Cox proportional hazards regression, risk in offspring of parents with BD for 7 psychotic disorders: Psychotic MD (PMD), psychotic BD (PBD), schizoaffective disorder (SAD), acute psychoses, psychosis NOS, delusional disorder (DD) and schizophrenia (SZ). Diagnoses were obtained from national registers. Study Results: In the offspring of BD parents, the hazard ratios (HR) for these 7 disorders formed an inverted U-shaped curve, rising from 2.98 for PMD, to peak at 4.49 for PBD and 5.25 for SAD, and then declining to a HR of 3.48 for acute psychoses and 3.22 for psychosis NOS, to a low of 2.19 for DD and 2.33 for SZ. A similar pattern of risks was seen in offspring of mothers and fathers affected with BD and in offspring predicted from age at onset in their BD parent. Conclusions: The BD-Associated risk for psychosis impacts most strongly on mood disorders, moderately on episodic psychotic syndromes, and least on chronic psychotic disorders. These results support prior clinical studies suggesting a qualitative difference in the familial substrate for psychosis occurring in BD and SZ.</p>}}, author = {{Kendler, Kenneth S. and Abrahamsson, Linda and Sundquist, Jan and Sundquist, Kristina}}, issn = {{0586-7614}}, language = {{eng}}, number = {{1}}, pages = {{157--165}}, publisher = {{Oxford University Press}}, series = {{Schizophrenia Bulletin}}, title = {{The Nature of the Familial Risk for Psychosis in Bipolar Disorder}}, url = {{http://dx.doi.org/10.1093/schbul/sbad097}}, doi = {{10.1093/schbul/sbad097}}, volume = {{50}}, year = {{2024}}, }