Dimensional psychopathology in preschool offspring of parents with bipolar disorder

Hagai Maoz*, Tina Goldstein, David A. Axelson, Benjamin I. Goldstein, Jieyu Fan, Mary Beth Hickey, Kelly Monk, Dara Sakolsky, Rasim S. Diler, David Brent, Satish Iyengar, David J. Kupfer, Boris Birmaher

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background The purpose of this study is to compare the dimensional psychopathology, as ascertained by parental report, in preschool offspring of parents with bipolar disorder (BP) and offspring of community control parents. Methods 122 preschool offspring (mean age 3.3 years) of 84 parents with BP, with 102 offspring of 65 control parents (36 healthy, 29 with non-BP psychopathology), were evaluated using the Child Behavior Checklist (CBCL), the CBCL-Dysregulation Profile (CBCL-DP), the Early Childhood Inventory (ECI-4), and the Emotionality Activity Sociability (EAS) survey. Teachers' Report Forms (TRF) were available for 51 preschoolers. Results After adjusting for confounders, offspring of parents with BP showed higher scores in the CBCL total, externalizing, somatic, sleep, aggressive, and CBCL-DP subscales; the ECI-4 sleep problem scale; and the EAS total and emotionality scale. The proportion of offspring with CBCL T-scores ≥2 SD above the norm was significantly higher on most CBCL subscales and the CBCL-DP in offspring of parents with BP compared to offspring of controls even after excluding offspring with attention deficit hyperactivity disorder and/or oppositional defiant disorder. Compared to offspring of parents with BP-I, offspring of parents with BP-II showed significantly higher scores in total and most CBCL subscales, the ECI-4 anxiety and sleep scales and the EAS emotionality scale. For both groups of parents, there were significant correlations between CBCL and TRF scores (r =.32-.38, p-values ≤.02). Conclusions Independent of categorical axis-I psychopathology and other demographic or clinical factors in both biological parents, preschool offspring of parents with BP have significantly greater aggression, mood dysregulation, sleep disturbances, and somatic complaints compared to offspring of control parents. Interventions to target these symptoms are warranted.

Original languageEnglish
Pages (from-to)144-153
Number of pages10
JournalJournal of Child Psychology and Psychiatry and Allied Disciplines
Issue number2
StatePublished - Feb 2014
Externally publishedYes


  • BP
  • dimensional psychopathology
  • offspring


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