Unipolar relatives in bipolar pedigrees: A search for elusive indicators of underlying bipolarity

In an effort to identify features indicative of underlying bipolarity within the unipolar relatives of bipolar probands, we compared unipolar relatives of bipolars with unipolar relatives of controls. Using data from the Yale‐NIMH Collaborative Study of Depression, we compared a number of demographi...

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Published in:	American journal of medical genetics Vol. 67; no. 5; pp. 445 - 454
Main Authors:	Blacker, Deborah, Faraone, Stephen V., Rosen, Amy E., Guroff, Juliet J., Adams, Phillip, Weissman, Myrna M., Gershon, Elliot S.
Format:	Journal Article
Language:	English
Published:	New York Wiley Subscription Services, Inc., A Wiley Company 20-09-1996 Wiley-Liss
Subjects:	Adult Adult and adolescent clinical studies Age of Onset Alcoholism - complications Alcoholism - epidemiology Biological and medical sciences bipolar disorder Bipolar Disorder - complications Bipolar Disorder - genetics Bipolar Disorder - psychology Bipolar disorders caseness index Demography Depression - psychology Dysthymic Disorder - complications Dysthymic Disorder - epidemiology Family Female Genetic Linkage Genetic Markers Humans linkage analysis major depression Male Medical sciences Mood disorders Morbidity Multivariate Analysis Odds Ratio Panic Disorder - complications Panic Disorder - epidemiology Pedigree Phenotype Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Regression Analysis Sex Characteristics Mood disorder Human Phenotype Theoretical model Criterion Family study Genetics Depression Bipolar disorder Psychopathology Diagnosis Statistical study
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Summary:	In an effort to identify features indicative of underlying bipolarity within the unipolar relatives of bipolar probands, we compared unipolar relatives of bipolars with unipolar relatives of controls. Using data from the Yale‐NIMH Collaborative Study of Depression, we compared a number of demographic and clinical features individually, and then developed a logistic regression model for the differences found. Unipolar relatives of bipolars were generally similar to relatives of controls, but they were older and more likely to suffer from more severe, even psychotic, depression, and somewhat less likely to report a brief transition into their illness. A multiple logistic regression model for observed differences was highly statistically significant, but had limited ability to discriminate effectively between the two groups. These findings suggest that more stringent diagnostic criteria might be beneficial if unipolar relatives are counted as affected in linkage studies of bipolar disorder. The ability of this strategy to improve the “clinical phenotype” is limited, however, and other approaches may be needed to identify features of underlying bipolarity and thus to define “caseness” for unipolar relatives in linkage analyses of bipolar disorder. © 1996 Wiley‐Liss, Inc.
Bibliography:	istex:D98C8E7DD0645353150E3CE88B0B9D4809882DCF ArticleID:AJMG2 ark:/67375/WNG-6KKTBT8H-7 National Institute of Mental Health - No. K21-MH01118; No. R01-MH28274 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0148-7299 1096-8628
DOI:	10.1002/(SICI)1096-8628(19960920)67:5<445::AID-AJMG2>3.0.CO;2-J