Family relations and paediatric bipolar disorder

Paediatric bipolar disorder (PBD) is often characterized by a more severe, remitting and chronic course of illness than adult onset bipolar disorder. Common features of PBD include increased irritability, elated moods and mixed states (of mania and depression) and a high rate of other mental-health problems such as Attention Deficit Hyperactivity Disorder (ADHD), oppositional defiant disorder, conduct disorder and anxiety disorders. Recent research has started to pay attention to the impact of parent-child relations on PBD with some studies finding significantly less warmth and greater tension and hostility than in other parent-child relationships. Researchers have also found that lower maternal warmth predicts a faster relapse after recovery from PBD. A U.S. study of 60 families compared 30 with a child with PBD to 30 unaffected families. Compared to the control group parent-child relationships in the PBD group were characterized by significantly less warmth, affection and intimacy and more quarreling and forceful punishment. Among the group with PBD elevated symptoms of mania, co-occuring ADHD, an earlier age of illness onset, living in a single-parent home and the presence of a parental mood disorder were associated with greater parent-child relationship difficulties.

Schenkel, Lindsay S. ... [et al] - Parent-child interactions in pediatric bipolar disorder Journal of Clinical Psychology April 2008, 64(4), 422-437