Examining the association of familial and social stress, trauma, and support on mood, anxiety, and behavioral symptoms and diagnoses in youth at risk for bipolar disorder and controls

Authors

Masoud Kamali, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: mkamali@mgh.harvard.edu.
Emma K. Stapp, Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Janice M. Fullerton, Neuroscience Research Australia, Randwick, NSW, Australia & School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Kensington, NSW, Australia.
Neera Ghaziuddin, Department of Psychiatry, Child and Adolescent Psychiatry Section, University of Michigan, Ann Arbor, MI, USA.
Leslie Hulvershorn, Indiana University School of Medicine, Indianapolis, IN, USA.
Melvin G. McInnis, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
Philip B. Mitchell, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Kensington, NSW, Australia.
Gloria Roberts, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Kensington, NSW, Australia.
Holly C. Wilcox, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
John I. Nurnberger, Indiana University School of Medicine, Indianapolis, IN, USA; Stark Neurosciences Research Institute, Departments of Psychiatry and Medical and Molecular Genetics, Indianapolis, IN, USA.

Document Type

Journal Article

Publication Date

7-20-2024

Journal

Journal of affective disorders

Volume

363

DOI

10.1016/j.jad.2024.07.125

Keywords

At-risk; Bipolar disorder; Life events; Stress; Trauma

Abstract

INTRODUCTION: Youth with a family history of bipolar disorder (At-Risk) have a higher risk of developing psychiatric disorders and experiencing environmental stressors than youth without such family history (Control). We studied the differential associations of familial and environmental factors on developing psychiatric diagnoses and symptoms, in At-Risk and Control youth. METHODS: At-Risk and Control youth (N = 466, ages 9-22) were systematically assessed for severity of symptoms, psychiatric diagnoses, and self-reported measures of stress and social support. We tested the association of family history and measures of stress or support with symptom severity and diagnoses. RESULTS: At-Risk youth had higher symptom severity scores and were more frequently diagnosed with psychiatric disorders (all p values < 0.001). When predicting mood symptom severity, family history had an interaction effect with stressful life events (p < 0.001) and number of distinct traumatic events (p = 0.001). In multivariate models, At-Risk status predicted anxiety disorders (OR = 2.7, CI 1.3-5.4, p = 0.005) and anxiety severity (Coefficient = 0.4, CI 0.2-0.7, p < 0.001) but not mood or behavioral disorder diagnoses or severity. LIMITATIONS: Measures of stress and social support were based on self-report. Not all participants had passed through the period of risk for developing the outcomes under study and the follow up period was variable. We could not fully study the differential impact of physical or sexual abuse due to low frequency of occurrence in controls. CONCLUSION: At-Risk youth exhibit more severe mood symptoms compared to Controls when exposed to similar levels of stress or trauma. At-Risk youth are also more prone to develop anxiety which may be a precursor for bipolar disorder.

APA Citation

Kamali, Masoud; Stapp, Emma K.; Fullerton, Janice M.; Ghaziuddin, Neera; Hulvershorn, Leslie; McInnis, Melvin G.; Mitchell, Philip B.; Roberts, Gloria; Wilcox, Holly C.; and Nurnberger, John I., "Examining the association of familial and social stress, trauma, and support on mood, anxiety, and behavioral symptoms and diagnoses in youth at risk for bipolar disorder and controls" (2024). GW Authored Works. Paper 5248.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5248

Department

Epidemiology