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Risk and coaggregation of major psychiatric disorders among first-degree relatives of patients with bipolar disorder: a nationwide population-based study

Published online by Cambridge University Press:  12 November 2018

Mu-Hong Chen Open the ORCID record for Mu-Hong Chen [Opens in a new window] ,
Ju-Wei Hsu ,
Kei-Lin Huang ,
Tung-Ping Su ,
Cheng-Ta Li ,
Wei-Chen Lin ,
Shih-Jen Tsai ,
Chih-Ming Cheng ,
Wen-Han Chang  and
Tai-Long Pan
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Mu-Hong Chen
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Ju-Wei Hsu
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Kei-Lin Huang
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Tung-Ping Su*
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
Cheng-Ta Li
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Wei-Chen Lin
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Shih-Jen Tsai
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Chih-Ming Cheng
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Wen-Han Chang
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
Tai-Long Pan
Affiliation:
School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan Research Center for Chinese Herbal Medicine and Research Center for Food and Cosmetic Safety, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
Tzeng-Ji Chen
Affiliation:
Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
Ya-Mei Bai*
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
*
Author for correspondence: Ya-Mei Bai, E-mail: [email protected] and Tung-Ping Su, E-mail: [email protected]
Author for correspondence: Ya-Mei Bai, E-mail: [email protected] and Tung-Ping Su, E-mail: [email protected]
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Abstract

Background

Bipolar disorder is a highly heritable mental illness that transmits intergeneratively. Previous studies supported that first-degree relatives (FDRs), such as parents, offspring, and siblings, of patients with bipolar disorder, had a higher risk of bipolar disorder. However, whether FDRs of bipolar patients have an increased risk of schizophrenia, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) remains unclear.

Methods

Among the entire population in Taiwan, 87 639 patients with bipolar disorder and 188 290 FDRs of patients with bipolar disorder were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with bipolar disorder.

Results

FDRs of patients with bipolar disorder were more likely to have a higher risk of major psychiatric disorders, including bipolar disorder (RR 6.12, 95% confidence interval (CI) 5.95–6.30), MDD (RR 2.89, 95% CI 2.82–2.96), schizophrenia (RR 2.64, 95% CI 2.55–2.73), ADHD (RR 2.21, 95% CI 2.13–2.30), and ASD (RR 2.10, 95% CI 1.92–2.29), than the total population did. These increased risks for major psychiatric disorders were consistent across different familial kinships, such as parents, offspring, siblings, and twins. A dose-dependent relationship was also found between risk of each major psychiatric disorder and numbers of bipolar patients.

Conclusions

Our study was the first study to support the familial coaggregation of bipolar disorder with other major psychiatric disorders, including schizophrenia, MDD, ADHD, and ASD, in a Taiwanese (non-Caucasian) population. Given the elevated risks of major psychiatric disorders, the public health government should pay more attention to the mental health of FDRs of patients with bipolar disorder.

Keywords

ADHDASDbipolar disorderfamilial co-aggregationfirst-degree relativesMDDschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 14 , October 2019 , pp. 2397 - 2404
Copyright
Copyright © Cambridge University Press 2018 

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