A family history study of rapid-cycling bipolar disorder

• Published in: Psychiatry research Vol. 48; no. 1; pp. 37 - 46
• Main Authors: Lish, Jennifer D., Gyulai, Laszlo, Resnick, Susan M., Kirtland, Alexander, Amsterdam, Jay D., Whybrow, Peter C., Price, R.Arlen
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.07.1993; Elsevier
• Subjects: Adult; Affective disorder; Biological and medical sciences; Bipolar Disorder - diagnosis; Bipolar Disorder - genetics; Bipolar Disorder - psychology; Depressive Disorder - diagnosis; Depressive Disorder - genetics; Depressive Disorder - psychology; Family History Research Diagnostic Criteria; Female; genetics; Humans; Male; mania; Medical sciences; Middle Aged; Phenotype; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Recurrence; Risk Factors; Social psychiatry. Ethnopsychiatry; Sociocultural environment; substance abuse; Substance-Related Disorders - diagnosis; Substance-Related Disorders - genetics; Substance-Related Disorders - psychology; Affective disorder; Family History Research Diagnostic Criteria; genetics; substance abuse; mania; Human; Mood disorder; Family story; Drug addiction; Sex; Depression; Bipolar disorder; Age; Comparative study
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/0165-1781(93)90111-S

Previous studies have yielded mixed evidence as to whether rapid-cycling bipolar disorder (four or more episodes per year) is associated with a distinctive pattern of patient characteristics and familial aggregation of affective disorder. In this study, Family History Research Diagnostic Criteria (FH-RDC) were used to interview 165 patients with rapid-cycling bipolar disorder, non-rapid-cycling bipolar disorder, or recurrent unipolar depressive disorder about the psychiatric history of 812 adult first-degree relatives. In a validity study, FH-RDC diagnoses were demostrated to agree reasonably well with best-estimate diagnoses by two psychiatrists/psychologists, based on direct interviews with the Structured Clinical Interview for DSM-III-R. Relatives of patients with recurrent unipolar depression were less likely to have bipolar disorder and more likely to have unipolar depression than were relatives of rapid-cycling or non-rapid-cycling bipolar patients. Rapid-cycling patients were younger and more likely to be female than non-rapid-cycling patients. The relatives of rapid cyclers did not differ significantly from those of non-rapid cyclers in the prevalence of bipolar disorder, unipolar disorder, rapid-cycling bipolar disorder, or substance abuse. However, there were nonsignificant trends for the relatives of rapid-cycling bipolar patients, compared with those of non-rapid-cycling bipolar patients, to have more substance abuse and less bipolar disorder given the presence of affective disorder.