Children of Bipolar Parents: A High-Risk Follow-up Study

双相情感障碍父母的孩子：一项高风险随访研究

基本信息

批准号：
7885972
负责人：
DAVID A AXELSON
金额：
$ 112.49万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2001
资助国家：
美国
起止时间：
2001-08-20 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7885972
关键词：
18 year old Accounting Adolescence Adolescent Adult Affect Affective Age Age of Onset Aggressive behavior Alcohol or Other Drugs use Amygdaloid structure Anatomy Anxiety Anxiety Disorders Asses Attention Attention deficit hyperactivity disorder Back Behavior Behavioral Biological Assay Biological Markers Biological Markers Bipolar Disorder Brain Child Child Development Childhood Circadian Rhythms Clinical Cognitive Communities Conduct Disorder Corpus striatum structure DNA DSM-IV Data Data Analyses Demographic Factors Detection Development Diagnosis Diffusion Magnetic Resonance Imaging Disease Disruptive Behavior Disorder Emotional Emotions Enrollment Environmental Risk Factor Event Exposure to Facial Expression Family Family history of Fathers Figs - dietary Functional disorder Funding Gender Genetic Genetic Polymorphism Goals Hormonal Image Imaging Techniques Impulsivity Incidence Intervention Interview Interviewer Label Lateral Life Light Longitudinal Studies Major Depressive Disorder Manic Measurement Measures Medial Mediator of activation protein Memory Mental Depression Mental disorders Mission Modeling Mood Disorders Moods Morbidity - disease rate Mothers National Institute of Mental Health Neurobiology Neurocognitive Neurocognitive Deficit Onset of illness Outcome Parents Pathogenesis Pathway interactions Pattern Performance Pharmaceutical Preparations Pharmacological Treatment Phase Phenotype Population Predisposition Prefrontal Cortex Problem behavior Process Progress Reports Protocols documentation Psychopathology Psychosocial Factor Puberty Publications Qualifying Questionnaires Recommendation Recording of previous events Recruitment Activity Regulation Relative (related person)Research Personnel Resources Risk Risk Factors Salivary Sample Size Sampling Sampling Studies Signal Transduction Sleep Specific qualifier value Stimulus Strategic Planning Study Section Substance Use Disorder Substance abuse problem Support System Symptoms Task Performances Testing Verbal Learning Youth age effect biosignature blind clinically relevant cognitive control cohort disorder control early onset emotion regulation endophenotype executive function family genetics follow-up functional disability gray matter high risk inattention information gathering instrument interest mood regulation neural circuit neuroimaging neuropsychological offspring outcome forecast prevent psychologic psychosocial relating to nervous system sex social stressor subclinical depression success suicidal behavior suicidal risk transmission process white matter young adult

项目摘要

DESCRIPTION (provided by applicant): This is a renewal of the protocol entitled "Children of Bipolar Parents: A High-Risk Follow-up Study" (NIMH #60952) also known as the Bipolar Offspring Study (BIOS). In line with the current NIMH Strategic Plan, BIOS has been investigating the additive effects of behavioral, affective, circadian/sleep, genetic, and psychosocial factors associated with the development of mood disorders in the offspring of parents with bipolar disorder (BP). Enrollment of BIOS sample was completed in July 2007 with 862 children recruited (509 from parents with BP and 353 from community control parents) and a retention rate of 87%. Interviewers, blind to parental diagnosis, assessed offspring every other year with a comprehensive battery of instruments. BIOS is beginning to elucidate a specific developmental progression to bipolarity in the offspring of parents with BP and as to date, offspring of parents with BP are at significantly higher risk to develop BP-I (OR: 19.5) or subsyndromal BP (OR: 31.2). Since most of the sample will enter the age of highest risk to develop BP and other mood disorders during the next funding period, we are proposing to continue to study this sample for 5 more years. For a subset of 200 children of parents with BP and control parents, we propose to measure neurocognitive functioning and activity in, and functional and anatomic connectivity between, neural regions implicated in the pathogenesis of BP, and obtain more precise measurements of puberty using salivary hormonal levels. We hypothesize that, relative to offspring of control parents, offspring of parents with BP will develop over follow-up: 1) higher rates of mood disorders and psychopathology (e.g., mood lability, disrupted sleep) and 2) deficits in neurocognitive functioning and neurocircuitry associated with emotion processing and regulation. In addition, in offspring of parents with BP, onset of BP or any mood disorder will be predicted by the combined effects of development, demographic factors, other psychiatric disorders, dimensional behavioral and mood phenotypes, family environmental factors, and their interactions. Within the subset of offspring of parents with BP who will have neurocognitive and neuroimaging data, onset of BP or any mood disorder will be predicted by abnormal neurocognitive functioning and activity and connectivity in neural circuitry for emotion processing and regulation, that in turn will be associated with sleep and circadian factors, puberty, and clinical and demographic risk factors identified above. Findings from this large study will help identify the initial symptoms and neurobiomarkers related to increased risk of BP in youth. Such findings will facilitate prompt diagnosis and interventions, thus preventing, or at least ameliorating, the negative effects of this severe illness in youth. PUBLIC HEALTH RELEVANCE: Bipolar disorder is a severe illness associated with considerable negative consequences for the normal development of the child and increased risk for suicide and substance abuse. However, little is known about the initial symptoms and the progression of this illness from childhood and adolescence to adulthood. The findings from this large study will help to identify the initial symptoms and some brain biological markers related to the increased risk to develop bipolar in youth. Such findings will advance the field so that prompt diagnosis and interventions are made, thus preventing or at least ameliorating the negative effects of this severe illness in youth.

描述（由申请人提供）：这是题为“双相情感障碍父母的孩子：一项高风险随访研究”（NIMH #60952）的方案的更新，也称为双相情感障碍后代研究（BIOS）。根据当前的 NIMH 战略计划，BIOS 一直在研究行为、情感、昼夜节律/睡眠、遗传和心理社会因素与双相情感障碍 (BP) 父母的后代情绪障碍发展相关的附加效应。 BIOS样本的招募工作于2007年7月完成，共招募了862名儿童（509名来自BP家长，353名来自社区对照家长），保留率为87%。采访者对父母的诊断视而不见，每隔一年用一套全面的仪器对后代进行评估。 BIOS 开始阐明患有 BP 的父母的后代向双相情感障碍的特定发展进程，迄今为止，患有 BP 的父母的后代患 BP-I（OR：19.5）或亚综合征 BP（OR：31.2）的风险明显更高）。由于大多数样本将在下一个资助期内进入患血压和其他情绪障碍的最高风险年龄，因此我们建议继续研究该样本5年。对于父母患有 BP 和对照父母的 200 名儿童的子集，我们建议测量与 BP 发病机制有关的神经区域的神经认知功能和活动，以及神经区域之间的功能和解剖连接，并使用唾液激素获得更精确的青春期测量水平。我们假设，相对于对照父母的后代，患有 BP 的父母的后代将在随访中出现：1）情绪障碍和精神病理学（例如情绪不稳定、睡眠中断）的发生率更高，2）神经认知功能和神经回路缺陷与情绪处理和调节有关。此外，在患有 BP 的父母的后代中，BP 或任何情绪障碍的发病将通过发育、人口因素、其他精神障碍、维度行为和情绪表型、家庭环境因素及其相互作用的综合影响来预测。在拥有神经认知和神经影像数据的患有 BP 的父母的后代子集中，BP 或任何情绪障碍的发作将通过异常的神经认知功能以及情绪处理和调节的神经回路的活动和连接来预测，而这反过来又与睡眠和昼夜节律因素、青春期以及上述临床和人口统计学风险因素。这项大型研究的结果将有助于确定与青少年高血压风险增加相关的初始症状和神经生物标志物。这些发现将有助于及时诊断和干预，从而预防或至少减轻这种严重疾病对青少年的负面影响。公共卫生相关性：双相情感障碍是一种严重疾病，会对儿童的正常发育产生相当大的负面影响，并增加自杀和药物滥用的风险。然而，人们对这种疾病的最初症状以及从儿童期、青少年期到成年期的进展知之甚少。这项大型研究的结果将有助于确定与青少年患双相情感障碍风险增加相关的初始症状和一些大脑生物标志物。这些发现将推动该领域的发展，以便及时进行诊断和干预，从而预防或至少减轻这种严重疾病对青少年的负面影响。