At risk for bipolar disorder: Bipolar offspring followed from adolescence into adulthood

Bipolar disorder, also known as manic depressive illness, is an often severe mental illness. The prevalence rate of bipolar disorder is about 1-2% among the general population. The pathogenesis of the illness is largely unknown. The most robust predictor for bipolar disorder is a positive family history. Children of patients with bipolar disorder (bipolar offspring) are thus at increased risk to develop bipolar disorder. Esther Mesman presented in her PhD thesis the results of a longitudinal study among bipolar offspring from the Netherlands. In this study bipolar offspring were followed from adolescence into adulthood.

Mesman concluded that at the age of 28 years bipolar offspring are indeed at increased risk to develop bipolar disorder (13%). Moreover, in general bipolar offspring are at risk for mood disorders (54%), often the recurrent type (33%). Mesman also found that bipolar disorder generally starts with a (mild) depressive episode, followed by (hypo)mania years later. Mild symptoms of mania, suicidal thoughts and sleep disturbances tended to precede full-blown (hypo)mania. Bipolar offspring reporting these symptoms are thus at high risk to develop bipolar disorder and should be closely monitored.

Mesman also evaluated potential risk markers among bipolar offspring in her PhD thesis. She studied the relation between stressful life events and the risk to develop a first mood episode. Moreover, she found evidence for an activated neuro-immune state among bipolar offspring. However, this finding was irrespective of the psychopathology status.

Findings of this thesis underscore the importance of close monitoring of mild symptomatology in this vulnerable population.