Categorical and dimensional psychopathology in Dutch and US offspring of parents with bipolar disorder: A preliminary cross-national comparison

Esther Mesman, Boris B. Birmaher, Benjamin I. Goldstein, Tina Goldstein, Eske M. Derks, Marloes Vleeschouwer, Mary Beth Hickey, David Axelson, Kelly Monk, Rasim Diler, Danella Hafeman, Dara J. Sakolsky, Catrien G. Reichart, Marjolein Wals, Frank C. Verhulst, Willem A. Nolen, Manon H. J. Hillegers*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objective: Accumulating evidence suggests cross-national differences in adults with bipolar disorder (BD), but also in the susceptibility of their offspring (bipolar offspring). This study aims to explore and clarify cross-national variation in the prevalence of categorical and dimensional psychopathology between bipolar offspringin the US and The Netherlands.

Methods: We compared levels of psychopathology in offspring of the Pittsburgh Bipolar Offspring Study (n=224) and the Dutch Bipolar Offspring Study (n=136) (age 10-18). Categorical psychopathology was ascertained through interviews using the Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS-PL), dimensional psychopathology by parental reports using the Child Behavior Checklist (CBCL).

Results: Higher rates of categorical psychopathology were observed in the US versus the Dutch samples (66% versus 44%). We found no differences in the overall prevalence of mood disorders, including BD-I or -II, but more comorbidity in mood disorders in US versus Dutch off spring (80% versus 34%). The strongest predictors of categorical psychopathology were maternal BD (OR: 1.72, p

Limitations: Preliminary measure of inter-site reliability.

Conclusions: We found cross-national differences in prevalence of categorical diagnoses of non-mood disorders in bipolar offspring, but not in mood disorder diagnoses nor in parent-reported dimensional psychopathology. Cross-national variation was only partially explained by between-sample differences. Cultural and methodological explanations for these findings warrant further study. (C) 2016 Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)95-102
Number of pages8
JournalJournal of Affective Disorders
Publication statusPublished - 15-Nov-2016


  • Bipolar offspring
  • High risk
  • Cross-national
  • Bipolar disorder
  • Mood disorder
  • Child Behavior Checklist
  • AGE

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